Individual
MRS. MARY LILLIAN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
121 S DIXIE AVE, COOKEVILLE, TN 38501-3401
(931) 528-2531
Mailing address
121 S DIXIE AVE, COOKEVILLE, TN 38501-3401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000156528
TN
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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