MR. Mark Vincent Lange, MPT

NPI #1558686428 in Slc, Utah

Provider Information

NPI Number: 1558686428
Entity Type: Individual
Name: MR. Mark Vincent Lange, MPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MPT
Enumeration Date: Apr 2, 2010
Last Updated: Jul 20, 2021

Practice Location

Address: FAIRFAX RD AT VIRGINIA ST
City: Slc
State: Utah
ZIP Code: 84103
Phone: (801) 536-3616

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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