NPI 1033685664

Mark Sevan Bourque, PTA

Practitioner Physical Therapy Assistant Mobile, AL

Practice location

Address: 1220 Azalea Rd, Mobile, AL 36693-2859
Phone: (125) 158-3165
Fax: (888) 539-6550

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA9163 (AL)

Other Physical Therapy Assistant providers in Alabama →

Registry record

NPI: 1033685664
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Oct 2018
Record last updated: 22 Oct 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.