Individual
MARK ANDREW CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NMD, HHP, CMT, MST
Contact information
Practice address
29822 WINDWOOD CIR, TEMECULA, CA 92591-2807
(949) 254-1740
Mailing address
29822 WINDWOOD CIR, TEMECULA, CA 92591-2807
(949) 254-1740
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
18590
CA
Other
Enumeration date
11/19/2016
Last updated
11/19/2016
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