Individual
MACKENZIE NEALON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
720 NORTHERN BLVD, GREENVALE, NY 11548-1319
(605) 868-2096
Mailing address
5008 W EQUESTRIAN PL, APT #208, SIOUX FALLS, SD 57106-5799
(605) 868-2096
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003051-1
NY
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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