Individual
AMY MACKANICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1404 HAY ST, BERLIN, PA 15530-1455
(814) 267-4212
(814) 267-5129
Mailing address
1404 HAY ST, BERLIN, PA 15530-1455
(814) 267-4212
(814) 267-5129
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC010555
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001539947002
—
PA
Enumeration date
04/01/2014
Last updated
04/01/2014
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