Individual
MISS AUDREY J MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
284 CUMBERLAND AVE, PORTLAND HIGH SCHOOL, PORTLAND, ME 04101-4927
(207) 874-8250
Mailing address
246 E BRIDGE ST, #19, WESTBROOK, ME 04092-4800
(207) 854-9244
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT109
ME
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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