Individual
MAKENZIE MAZIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DSCPT
Contact information
Practice address
5131 BALLYCASTLE CIR, ALEXANDRIA, VA 22315-5566
(703) 786-3352
Mailing address
5131 BALLYCASTLE CIR, ALEXANDRIA, VA 22315-5566
(703) 786-3352
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203359
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F8710015
CAREFIRST BLUE CROSS BLUE SHIELD
DC
Enumeration date
01/11/2006
Last updated
04/12/2023
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