Individual
MACKENZIE GRACE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 VISTA DR, MOORE, SC 29369-9482
(256) 682-8648
Mailing address
119 VISTA DR, MOORE, SC 29369-9482
(256) 682-8648
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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