Individual
BRENT D MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4334 FOX VALLEY CENTER DR, SUITE C, AURORA, IL 60504-7945
(630) 236-7544
(630) 236-7574
Mailing address
25731 MEADOWLAND CIR, PLAINFIELD, IL 60585-2830
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-012918
IL
Other
Enumeration date
09/28/2006
Last updated
02/13/2009
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