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Individual

MARK MCKENZIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2375 NE HIGHWAY 99W, MCMINNVILLE, OR 97128-9201
(503) 434-1183
Mailing address
1885 NW ALDER ST, MCMINNVILLE, OR 97128-3039
(503) 560-6526

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3488ATI
OR

Other

Enumeration date
05/30/2012
Last updated
06/02/2014
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