Organization
MACK OCCUPATIONAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA GONZALES MACK MS OTR/L (OCCUPATIONAL THERAPIST)
(336) 817-4278
Entity
Organization
Contact information
Practice address
1213 LLEWELLYN RD, MOUNT PLEASANT, SC 29464-3816
(336) 817-4278
Mailing address
1213 LLEWELLYN RD, MOUNT PLEASANT, SC 29464-3816
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3730
SC
Other
Enumeration date
06/14/2012
Last updated
06/26/2012
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