Individual
MACKENZIE COLE INTLEHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 OLYMPIC PLAZA CIR STE 600, TYLER, TX 75701-1954
(903) 596-3488
Mailing address
700 OLYMPIC PLAZA CIR STE 600, TYLER, TX 75701-1954
(903) 596-3488
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA11528
TX
Other
Enumeration date
12/28/2017
Last updated
04/04/2024
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