Individual
MACKENZIE B WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 CREST RD, SAINT ALBANS, VT 05478-9701
(802) 524-4554
Mailing address
12 CREST RD, SAINT ALBANS, VT 05478-9701
(802) 524-4554
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
023473
NY
363A00000X
Physician Assistant
Primary
055.0031576
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/03/2018
Last updated
10/20/2022
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