Individual
MR. MARK ALBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1957 THOMPSON RD., COOS BAY, OR 97420-2031
(541) 266-7050
(541) 266-0180
Mailing address
1957 THOMPSON RD., COOS BAY, OR 97420-2031
(541) 266-7050
(541) 266-0180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0842
HI
225100000X
Physical Therapist
Primary
0878
OR
225100000X
Physical Therapist
7816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291112
—
OR
01
—
410247401
REGENCE BC BS
OR
Enumeration date
01/30/2007
Last updated
05/18/2012
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