Individual
CARL DAWES MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
17 AFHEA LN, GILBERTSVILLE, KY 42044-8806
(270) 362-5004
Mailing address
17 AFEHA LANE, PO BOX 430, GILBERTSVILLE, KY 42044
(270) 362-5004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A00108
KY
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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