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Individual

GEORGE MACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
20 THOMPSON AVE E, SUITE 103, SAINT PAUL, MN 55118-3187
(651) 455-2447
Mailing address
7541 9TH ST N, OAKDALE, MN 55128-6626
(651) 748-4338

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1670
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
087018800
MN
Enumeration date
11/03/2006
Last updated
07/02/2009
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