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Mr. Mark Joseph Colston, ATC,
Specialist in Peoria, Illinois
NPI 1265585517

Mark Joseph Colston is a Specialist based in Mackinaw, IL. Mark Joseph Colston practices in Peoria, IL and has the professional credentials of ATC,. The NPI Number for Mark Joseph Colston is 1265585517 and holds a License No. 36000941A (Illinois).

The current practice location address for Mark Joseph Colston is 1501 W Bradley Ave, Peoria, IL and can be reached out via phone at 765-376-2657.

Location: 1501 W Bradley Ave, Peoria, IL, 61755-8991
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265585517
Provider Name
Mark Joseph Colston
Credential
ATC,
Provider Entity Type
Individual
Gender
Male
Address
1501 W Bradley Ave, Peoria, IL, 61755-8991
Phone Number
765-376-2657
Fax Number
Provider Enumeration Date
01/19/2007
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
1501 W Bradley Ave
City
Peoria
State
Illinois
Zip
61625-2417
Phone Number
765-376-2657
Fax Number
person
Provider Business Mailing Address Details
Address
1501 W Bradley Ave
City
Peoria
State
Illinois
Zip
61625-2417
Phone Number
765-376-2657
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
36000941A (Indiana)
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.
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