Individual
MACKENZIE MODRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1447 N. HARRISON ST, SAGINAW, MI 48602-4860
(989) 280-9555
Mailing address
5259 S GLEN OAK DR, SAGINAW, MI 48603-1764
(989) 280-9555
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010097
MI
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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