Mark Allen Fanning, SA-C
NPI #1386829281 in Glenn Rose, Texas
Provider Information
- NPI Number
- 1386829281
- Entity Type
- Individual
- Name
- Mark Allen Fanning, SA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist, Other - Surgical Technologist
- Credential
- SA-C
- Enumeration Date
- Jan 9, 2008
- Last Updated
- Jan 9, 2008
Practice Location
- Address
- 408 GLENNWOOD
- City
- Glenn Rose
- State
- Texas
- ZIP Code
- 76043
- Phone
- (254) 897-1445
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other - Surgical Technologist — Surgical Technologist |
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