Individual
MACKENZIE DUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1450 E FAIRVIEW AVE STE 201, MERIDIAN, ID 83642-1819
(208) 887-6757
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171-1185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-7495
ID
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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