Individual
MR. TROY ELGIN MACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRC
Contact information
Practice address
6273 W JEWELL AVE # 109, LAKEWOOD, CO 80232-7113
(720) 829-3093
Mailing address
6273 W JEWELL AVE # 109, LAKEWOOD, CO 80232-7113
(720) 829-3093
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
07-112-1217
CO
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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