Individual
MACKENZIE SUE RAE WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 STADIUM DRIVE, 2ND FLOOR, BOULDER, CO 80309-0001
(303) 315-9900
(303) 315-9902
Mailing address
6491 CRESTBROOK DR, MORRISON, CO 80465-2230
(303) 642-6063
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0021024
CO
Other
Enumeration date
12/30/2025
Last updated
12/30/2025
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