Individual
MACKENZIE RAE DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10269 HIGHWAY 789, RIVERTON, WY 82501-8829
(307) 857-9458
Mailing address
PO BOX 1989, RIVERTON, WY 82501-0240
(307) 857-9458
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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