Individual
JOSHUA L MACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1551 N OAKLAND AVE, BOLIVAR, MO 65613-3012
(417) 326-8700
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 326-6000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2008002899
MO
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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