Individual
MR. ERIC N MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
265 TOWNSHIP LINE RD, ELKINS PARK, PA 19027-2221
(215) 379-2700
Mailing address
2738 ROSSITER AVE, ROSLYN, PA 19001-1431
(215) 659-6630
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OPOO3261L
PA
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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