Individual
JEFFERY MACKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3404 DAVIE RD APT 301, DAVIE, FL 33314-1628
(954) 496-0542
Mailing address
3404 DAVIE RD APT 301, DAVIE, FL 33314-1628
(954) 496-0542
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28770
FL
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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