Individual
MACKENZIE LYNN BOSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
101 ELM AVE SE, ROANOKE, VA 24013-2222
(540) 985-8483
Mailing address
619 S GARFIELD ST, ARLINGTON, VA 22204-2438
(570) 617-3626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/22/2023
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