Individual
MARK B MCKINLEY
Active
Individual
MARK B MCKINLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207940
VA
225100000X
Physical Therapist
7559
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7559
LICENSE
SC
01
—
C09813
MEDICARE IDENTIFICATION NUMBER
VA
Enumeration date
03/05/2015
Last updated
10/30/2020
Update your record
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