MARK KLOCKO

SHREVEPORT, LA
NPI1780070763
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: LA  A6908)
Enumeration Date2015-04-07
Last Update Date2015-04-07
Business Address
-- MARK KLOCKO PTA
1401 ODEN ST UNIT 25
SHREVEPORT, LA 71104-3843
Phone number: 318-560-0627
Mailing Address
-- MARK KLOCKO PTA
1401 ODEN ST UNIT 25
SHREVEPORT, LA 71104-3843
Phone number: 318-560-0627
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