Individual
MR. CLIFTON JAMES MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT/L
Contact information
Practice address
1070 STONUM LN, MANTECA, CA 95337-9490
(209) 239-4258
(209) 239-4258
Mailing address
1777 W YOSEMITE AVE, MANTECA, CA 95337-5130
(209) 825-3696
(209) 825-3697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1099
CA
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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