Individual
MACKI MOHAMMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4902 N 19TH AVE, PHOENIX, AZ 85015-3440
(605) 214-8632
Mailing address
7004 S 58TH AVE, LAVEEN, AZ 85339-2265
(605) 215-7364
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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