Individual
MARK JOHN FERNANDO YACO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-4360
Mailing address
212 WASHINGTON AVE APT 705, TOWSON, MD 21204-4720
(443) 722-4367
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21885
MD
Other
Enumeration date
09/28/2019
Last updated
09/28/2019
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