JACK MARK

LOS ANGELES, CA
NPI1699228619
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: DE  CPO01066)
Additional Taxonomies222Z00000X 
(Licence: DE  CPO01066)
Enumeration Date2016-07-26
Last Update Date2016-07-26
Business Address
Mr. JACK MARK CPO
3160 GENEVA ST
LOS ANGELES, CA 90020-1117
Phone number: 213-368-3374
Mailing Address
Mr. JACK MARK CPO
3160 GENEVA ST
LOS ANGELES, CA 90020-1117
Phone number: 213-368-3374
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