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Individual

MARK FREDERICK ACKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
1055 RIVERSIDE AVE, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385
Mailing address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-392
ID

Other

Enumeration date
08/22/2006
Last updated
07/19/2024
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