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1194748863
MARK S SHORT
FORT LEONARD WOOD, MO
NPI
1194748863
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MO 2011012296)
Enumeration Date
2006-07-25
Last Update Date
2021-05-06
Business Address
MARK S SHORT PA-C
126 MISSOURI AVE MCXP-CCS-CR
FORT LEONARD WOOD, MO 65473-8952
Phone number: 573-596-0417
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Mailing Address
MARK S SHORT PA-C
126 MISSOURI AVE MCXP-CCS-CR
FORT LEONARD WOOD, MO 65473-8952
Phone number: 573-596-0417
Copy
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