Individual
MARK HALVORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4668 PEMBROKE BLVD STE 115, VIRGINIA BEACH, VA 23455-6423
(577) 648-8562
(757) 648-8564
Mailing address
4668 PEMBROKE BLVD STE 115, VIRGINIA BEACH, VA 23455-6423
(577) 648-8562
(757) 648-8564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305212181
VA
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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