Individual
ERIC NICHOLAS MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
6160 TUTT BLVD, COLORADO SPRINGS, CO 80923-3500
(719) 540-2150
Mailing address
4228 WINDING WAY CT, DALLAS, TX 75287-2767
(802) 558-6656
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
433776
TX
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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