Individual
MRS. MACKENZI KAY GATZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
71 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 717-6431
(605) 717-8033
Mailing address
71 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 717-6431
(605) 717-8033
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1169
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1169
SOUTH DAKOTA BOARD OF MEDICAL AND OSTEOPATHIC EXAMINERS
SD
Enumeration date
10/31/2018
Last updated
10/31/2018
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