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General NPI Number Information
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NPI Number | 1427249804
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Entity Type | Organization
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Legal Business Name | MARK S. PLANTE
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 725 E. MAIN STREET SUITE 6
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City | SOMERTON
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State | AZ
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Zip | 85350
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Country | US
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Telephone | 982-722-7207
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Fax |
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Provider Business Mailing Address
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Address Line | 381 S MAIN ST
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City | YUMA
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State | AZ
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Zip | 85364-2340
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Country | US
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Telephone | 928-343-7828
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | CINDY PLANTE
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Credential |
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Telephone | 928-343-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2608
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License Number State | AZ
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