Individual
TIFFANY L MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-7203
(608) 262-5624
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1922-023
WI
Other
Enumeration date
04/12/2006
Last updated
02/22/2018
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