Individual
MAXIE MCKAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
634 E ANGIE CIR, MIDVALE, UT 84047-1354
(385) 529-3508
Mailing address
177 W PRICE AVE, SOUTH SALT LAKE, UT 84115-4345
(385) 315-1048
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155866502
—
UT
Enumeration date
03/07/2022
Last updated
03/07/2022
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