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1205537057
MARK LUIS MICLAT
NEW YORK, NY
NPI
1205537057
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NY 048774)
Enumeration Date
2023-03-16
Last Update Date
2024-08-06
Business Address
MARK LUIS MICLAT PT, DPT
143 E 34TH ST
NEW YORK, NY 10016-4713
Phone number: 646-841-1400
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Mailing Address
MARK LUIS MICLAT PT, DPT
31 E 32ND ST FL 4
NEW YORK, NY 10016-5595
Phone number: 212-759-2282
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