Individual
MACKENZIE RAE SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1543 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-2273
Mailing address
1019 VALLEY VIEW AVE APT B8, MORGANTOWN, WV 26505-3516
(304) 494-1792
(304) 494-1792
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2395
WV
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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