Individual
MACKENZIE RENEE POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
507 N 17TH ST, MILWAUKEE, WI 53233-2104
(815) 979-4787
Mailing address
507 N 17TH ST, MILWAUKEE, WI 53233-2104
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
10/25/2024
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