Individual
MACKENZIE DENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1345 UNITY PL STE 235, LAFAYETTE, IN 47905-5761
(765) 446-5065
(765) 446-5170
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
177011
IN
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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