Individual
MCKENZIE MYA SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25012 104TH AVE SE STE C, KENT, WA 98030-2821
(253) 499-9049
Mailing address
2720 S HIGHLAND AVE APT 417, LOMBARD, IL 60148-5393
(815) 412-4280
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008915
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EAV826943729
BCBS
IL
Enumeration date
02/09/2023
Last updated
02/09/2023
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