Individual
MACKENZIE D FLAHAUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 S MAIN ST, BELLE RIVE, IL 62810-1228
(618) 316-1626
Mailing address
16680 N MILLIKIN LN, MOUNT VERNON, IL 62864-7925
(689) 239-1432
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
IL
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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