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Individual

MR. MARK E. LESTER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC/CREDENTIALS, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Mailing address
1 HERITAGE LN, NATICK, MA 01760-2610
(508) 233-5488

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
05007896A
IN

Other

Enumeration date
11/09/2005
Last updated
07/09/2007
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