Individual
MARK BOURASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1500 WEISS ST, SAGINAW, MI 48602-5251
(989) 497-2500
(989) 321-4948
Mailing address
1220 E REID RD, GRAND BLANC, MI 48439-8835
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003302
MI
Other
Enumeration date
03/05/2015
Last updated
03/06/2015
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