Individual
GEOFFREY MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
2025 E EGBERT ST, BRIGHTON, CO 80601
(855) 840-7257
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0003547
CO
Other
Enumeration date
07/13/2015
Last updated
07/10/2019
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