Individual
DEVERION DARNELL MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2055 LINCOLN AVE, PASADENA, CA 91103-1324
(626) 798-6793
Mailing address
2055 LINCOLN AVE, PASADENA, CA 91103-1324
(626) 798-6793
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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