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Individual

BRITTANY JEAN MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOT,OTR/L

Contact information

Practice address
901 DIVISION ST NW, MANDAN, ND 58554-1641
(701) 751-6500
Mailing address
1204 WHITMAN RD, MANDAN, ND 58554-4813
(701) 220-9310

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
6142
AZ
225XP0200X
Pediatric Occupational Therapist
Primary
1412
ND

Other

Enumeration date
03/25/2015
Last updated
12/01/2022
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