Individual
MARK ANTHONY RETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
300 GRANT AVE, LAKE KATRINE, NY 12449-5340
(845) 336-3500
Mailing address
24 MONTGOMERY ST, COHOES, NY 12047-3910
(518) 605-0100
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001145
NY
Other
Enumeration date
05/15/2022
Last updated
05/15/2022
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