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1649242694
MARK J CANAVAN
WYNNEWOOD, PA
NPI
1649242694
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: PA MA003209L)
Enumeration Date
2006-02-03
Last Update Date
2007-07-08
Business Address
-- MARK J CANAVAN PAC
100 W LANCASTER AVE
WYNNEWOOD, PA 19096
Phone number: 610-645-2420
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Mailing Address
-- MARK J CANAVAN PAC
PO BOX 3012
WILMINGTON, DE 19804-0012
Phone number: 800-456-4629
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