Individual
MS. JANAVICE ANN MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003515
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OF32955
BC/BS
MI
Enumeration date
10/16/2006
Last updated
03/27/2023
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