Individual
MARK MAKANI THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 HIGHWAY 89 NORTH, PRESCOTT, AZ 86313-5001
(928) 445-4860
Mailing address
1998 PRESCOTT LAKES PKWY APT 237, PRESCOTT, AZ 86301-7832
(623) 271-5366
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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