Individual
MARK MAZENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 ROTHWOOD AVE APT B9, MADISON, TN 37115-4936
(256) 527-8721
Mailing address
600 ROTHWOOD AVE APT B9, MADISON, TN 37115-4936
(256) 527-8721
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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