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1700370020
MARK DIAZ
MADISON, WI
NPI
1700370020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WI 4404-23)
Enumeration Date
2018-06-20
Last Update Date
2018-06-20
Business Address
Mr. MARK DIAZ PA-C
77 S OAKBRIDGE CT APT 105
MADISON, WI 53717-2030
Phone number: 562-659-3459
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Mailing Address
Mr. MARK DIAZ PA-C
77 S OAKBRIDGE CT APT 105
MADISON, WI 53717-2030
Phone number:
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