Individual
MACKENZIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
32 LUPINE LN, SELINSGROVE, PA 17870-9683
(570) 259-6739
Mailing address
32 LUPINE LN, SELINSGROVE, PA 17870-9683
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
708029
PA
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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