Individual
MACKENZIE ROSE BETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
721 W 13TH ST STE 321, JASPER, IN 47546-1857
(812) 996-7918
Mailing address
PO BOX 1028, JASPER, IN 47547-1028
(812) 996-8478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002980A
IN
363A00000X
Physician Assistant
—
IN
Other
Enumeration date
06/17/2020
Last updated
12/10/2020
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