Individual
MACKENZIE JO ELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
217 INGLESIDE AVE APT A, MARIETTA, OH 45750-3477
(503) 410-9499
Mailing address
217 INGLESIDE AVE APT A, MARIETTA, OH 45750-3477
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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