Individual
MICHAEL TYRONE MACKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
2541 WINTERVILLE DR, AUGUSTA, GA 30909-0623
(706) 231-7686
Mailing address
2541 WINTERVILLE DR, AUGUSTA, GA 30909-0623
(706) 231-7686
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000398
GA
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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