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Individual

COREY KEITH MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1619 SANTA MONICA BLVD, SANTA MONICA, CA 90404-1807
(310) 329-5855
Mailing address
6202 S PACIFIC COAST HWY, APARTMENT 11, REDONDO BEACH, CA 90277-5928

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
07/15/2013
Last updated
07/15/2013
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