IndividualActive
Mark Wilk
NPI 1790905131 · Home Modifications Contractor · Phoenix, AZ
Provider details
- NPI number
- 1790905131
- Entity type
- Individual
- Primary specialty
- Home Modifications ContractorOther Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- ROC 165112 (AZ)
Specialties & taxonomies
Other Service Providers
Practice location
2011 W. Davis Road
Phoenix, AZ 85023-7802
Phone: (602) 942-6421
Fax: (602) 564-2840
Approximate (ZIP-level) locationGet directions
Mailing address
2011 W. Davis Road
Phoenix, AZ 85023-7802
Registry dates
- Enumerated
- 2007-04-26
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.