Individual
DR. MARK E. MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070-5530
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DRIVE, LARAMIE, WY 82070-5530
(800) 446-5684
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
8740A
WY
207X00000X
Orthopaedic Surgery Physician
MD433175
PA
Other
Enumeration date
01/23/2008
Last updated
09/11/2020
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