Individual
MACKENZIE DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
660 BANNOCK ST, DENVER, CO 80204-4506
(036) 024-3863
Mailing address
660 BANNOCK ST, DENVER, CO 80204-4506
(036) 024-3863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006000
CO
Other
Enumeration date
10/10/2019
Last updated
10/13/2021
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