Individual
MARLA MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1028 RIVER FOREST PT, LAWRENCEVILLE, GA 30045-2600
(313) 850-4400
Mailing address
1028 RIVER FOREST PT, LAWRENCEVILLE, GA 30045-2600
(313) 850-4400
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0276
MS
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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