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General NPI Number Information
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NPI Number | 1841852399
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Entity Type | Organization
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Legal Business Name | MARK P WALSH DO LLC
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 07/05/2019
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Provider Practice Location Address
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Address Line | 1623 MORGANTOWN RD
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City | READING
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State | PA
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Zip | 19607-9455
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Country | US
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Telephone | 610-796-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 619 N GARFIELD AVE
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City | SCRANTON
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State | PA
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Zip | 18504-1813
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Country | US
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Telephone | 570-346-3297
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK P WALSH
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Credential | DO
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Telephone | 570-346-3297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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