Individual
GREGORY THOMAS MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACE-CMES
Contact information
Practice address
2624 BILLINGSLEY RD, COLUMBUS, OH 43235-1924
(614) 989-1465
Mailing address
2624 BILLINGSLEY RD, COLUMBUS, OH 43235-1924
(614) 989-1465
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
C10803
OH
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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