Individual
MISS MACKENZIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 WALDEN HEIGHTS DR APT 802, IRMO, SC 29063-7871
(478) 696-6135
Mailing address
100 WALDEN HEIGHTS DR APT 802, IRMO, SC 29063-7871
(478) 696-6135
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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