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Individual

KATHLEEN MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6372 MECHANICSVILLE TPKE STE 105, MECHANICSVILLE, VA 23111-4705
(804) 559-4625
(804) 559-4627
Mailing address
6372 MECHANICSVILLE TPKE STE 105, MECHANICSVILLE, VA 23111-4705
(804) 559-4625
(804) 559-4627

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2101002152
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2101002152
STATE LICENSE
VA
Enumeration date
06/01/2017
Last updated
03/17/2018
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