Individual
MRS. BREE ANNE MACKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
382 PARTRIDGE LN, REXBURG, ID 83440-3593
(208) 351-1599
Mailing address
382 PARTRIDGE LN, REXBURG, ID 83440-3593
(208) 351-1599
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-5317
ID
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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