Individual
KATHERINE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2680 S AVENUE B, YUMA, AZ 85364-6901
(928) 336-1476
(928) 336-9622
Mailing address
2400 S AVENUE A, YUMA, AZ 85364-7127
(928) 344-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10850
AZ
363A00000X
Physician Assistant
12482391-1206
UT
Other
Enumeration date
12/02/2021
Last updated
01/07/2025
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