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1922002831
MARK W STATHAM
FLAGSTAFF, AZ
NPI
1922002831
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AZ AZ2618)
Enumeration Date
2005-06-08
Last Update Date
2008-03-04
Business Address
-- MARK W STATHAM PT
715 N BEAVER ST
FLAGSTAFF, AZ 86001
Phone number: 928-773-1601
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Mailing Address
-- MARK W STATHAM PT
715 N BEAVER ST
FLAGSTAFF, AZ 86001
Phone number: 928-773-1601
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