Individual
MARK T WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
3906 BREEZEPORT WAY, APT 105, SUFFOLK, VA 23435-1080
(484) 883-4242
Mailing address
3906 BREEZEPORT WAY, APT 105, SUFFOLK, VA 23435-1080
(484) 883-4242
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0126001906
VA
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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