MARK ROBERT PEACOCK

PORTLAND, OR
NPI1982370094
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OR  9978)
Enumeration Date2021-08-18
Last Update Date2021-08-18
Business Address
MARK ROBERT PEACOCK PTA
6003 SE 136TH AVE
PORTLAND, OR 97236-4567
Phone number: 971-978-1268
Mailing Address
MARK ROBERT PEACOCK PTA
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE, OR 97222-4628
Phone number:
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