Doctor Name: | MR. MARK RAYMOND WESTRA |
NPI Number: | 1063758597 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 2118 |
Business Practice Address: | 1610 John Orr Dr Tifton, GA - 317943682 |
Business Phone Number: | 2293914580 |
Business Fax Number: | 2293914585 |
Mailing Address: | 604 Us Highway 19 N, AMERICUS |
State: | GA |
Postal Code: | 317198300 |
Phone Number: | 2299388072 |
Fax Number: | 2293914585 |
NPI Enumeration Date: | 01/03/2013 |
NPI Last Update Date: | 01/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2118 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |