Individual
MAKENZIE L CORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
24-01371
KS
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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