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1033685664
MARK SEVAN BOURQUE
MOBILE, AL
NPI
1033685664
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AL PTA9163)
Enumeration Date
2018-10-22
Last Update Date
2018-10-22
Business Address
MARK SEVAN BOURQUE PTA
1220 AZALEA RD
MOBILE, AL 36693-2859
Phone number: 125-158-3165
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Mailing Address
MARK SEVAN BOURQUE PTA
1220 AZALEA RD
MOBILE, AL 36693-2859
Phone number: 125-158-3165
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