Doctor Name: | MARK JOHN HAINES |
NPI Number: | 1215294962 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC |
License Number: | 25MT00001900 |
Business Practice Address: | 520 Jacksonville Road Mount Holly, NJ - 080601239 |
Business Phone Number: | 6092670837 |
Business Fax Number: | 6097020835 |
Mailing Address: | 14 Lancashire Drive, MOUNT HOLLY |
State: | NJ |
Postal Code: | 080603275 |
Phone Number: | 6092618824 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2012 |
NPI Last Update Date: | 04/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 25MT00001900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |