Individual
KATHERINE A MACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
289 COUNTY RD, WINDSOR, VT 05089-9000
(802) 674-7300
(802) 674-7349
Mailing address
289 COUNTY RD, WINDSOR, VT 05089-9000
(802) 674-7300
(802) 674-7349
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030741
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000238
—
VT
Enumeration date
08/21/2006
Last updated
07/29/2009
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