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Individual

JACKIE A MACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
EXIT 102 OFF I - 40 1/2 MI SOUTH, SAN FIDEL, NM 87049-0130
(505) 552-5385
(505) 552-5473
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 551-5385
(505) 552-5473

Taxonomy

Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
03000684
NM

Other

Enumeration date
03/13/2008
Last updated
03/13/2008
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