Individual
MR. MARK STEPHEN PLANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
381 S MAIN ST, YUMA, AZ 85364-2340
(928) 580-5769
(928) 782-1019
Mailing address
381 S MAIN ST, YUMA, AZ 85364-2340
(928) 580-5769
(928) 782-1019
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2608
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690330
—
AZ
01
—
AZ0460990
BLUE CROSS BLUE SHIELD ID
AZ
Enumeration date
07/13/2005
Last updated
11/28/2007
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