Individual
MARK TESANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8601 N KENTUCKY AVE STE A, EVANSVILLE, IN 47725-6371
(812) 469-6877
Mailing address
6673 MASSACHUSETTS ST, MERRILLVILLE, IN 46410-3518
(219) 808-3171
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
30003311A
IN
227900000X
Registered Respiratory Therapist
Primary
RT13364
FL
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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