Individual
MALLORY MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8613 N 30TH ST, OMAHA, NE 68112-1852
(402) 451-2125
(402) 451-2401
Mailing address
8613 N 30TH ST, OMAHA, NE 68112-1852
(402) 451-2125
(402) 451-2401
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13668
NE
183500000X
Pharmacist
23519
IA
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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