Individual
MR. GARY MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
18727 JEANETTE ST, SOUTHFIELD, MI 48075-1728
(256) 457-4211
(248) 569-8337
Mailing address
18727 JEANETTE ST, SOUTHFIELD, MI 48075-1728
(256) 457-4211
(248) 569-8337
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704257988
MI
Other
Enumeration date
03/27/2016
Last updated
03/27/2016
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