Individual
MACKENZIE RAE GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 CHURCH ST, JEANERETTE, LA 70544-4407
(337) 276-6018
Mailing address
3710 HIGHWAY 457, ALEXANDRIA, LA 71302-9293
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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