Colston, Mark Joseph

Colston, Mark Joseph is an sole proprietor health care provider with primary practice located at 1501 W Bradley Ave , Peoria IL 61625-2417. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Colston, Mark Joseph can be contacted via phone (765) 376-2657.

Contact Information

Primary practice address
1501 W Bradley Ave Peoria IL 61625-2417
Phone: (765) 376-2657
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36000941A Indiana

Profile Details

NPI number 1265585517
LBN Legal business name Colston, Mark Joseph
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2007
Last updated Feb 21st, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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