Individual
MR. JAKE MATTHEW MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
350 CRAG RD, PANAMA CITY BEACH, FL 32407-7013
(760) 277-3999
Mailing address
350 CRAG RD, PANAMA CITY BEACH, FL 32407-7013
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
NC
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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