MARK WILSON

PHILADELPHIA, PA
NPI1750736088
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261Q00000X Clinic/Center
(Licence: PA  A-6418104)
Enumeration Date2016-04-23
Last Update Date2016-04-23
Business Address
Mr. MARK WILSON
5313 OGDEN ST
PHILADELPHIA, PA 19139-1438
Phone number: 215-600-9477
Mailing Address
Mr. MARK WILSON
5313 OGDEN ST
PHILADELPHIA, PA 19139-1438
Phone number: 215-600-9477
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