Individual
MR. MARK B BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1590 E POLSTON AVE STE B, POST FALLS, ID 83854-5218
(208) 777-4242
Mailing address
2355 E GRANDVIEW DR, COEUR D ALENE, ID 83815-7932
(208) 765-0799
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT-1703
ID
Other
Enumeration date
10/24/2006
Last updated
09/11/2007
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