Individual
MRS. LAURA M. MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1288 VALLEY FORGE RD, SUITE 69, PHOENIXVILLE, PA 19460-2687
(610) 933-9483
(610) 933-4080
Mailing address
617 COATES LN, KING OF PRUSSIA, PA 19406-2557
(610) 279-7754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN600895
PA
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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