Individual
MACKENZIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
474 W 200 N, ST GEORGE, UT 84770-4505
(435) 634-5600
Mailing address
474 W 200 N, ST GEORGE, UT 84770-4505
(435) 634-5600
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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