MARK VINCENT I SORIANO MENDOZA

CHUBBUCK, ID
NPI1124831714
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT3640)
Enumeration Date2025-01-29
Last Update Date2025-01-29
Business Address
MARK VINCENT I SORIANO MENDOZA DPT
763 BOYD ST
CHUBBUCK, ID 83202-2941
Phone number: 208-417-9605
Mailing Address
MARK VINCENT I SORIANO MENDOZA DPT
763 BOYD ST
CHUBBUCK, ID 83202-2941
Phone number: 208-417-9605
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