Individual
TASHA S MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7233 E BASELINE RD STE 126, MESA, AZ 85209-5007
(480) 699-2222
(480) 699-3033
Mailing address
6745 E SUPERSTITION SPRINGS BLVD APT 1001, MESA, AZ 85206-4364
(480) 699-2222
(480) 699-3033
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5521
AZ
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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