Individual
MACKENZIE FALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2ND RECON BLDG A-71, CAMP LEJEUNE, NC 28547
(910) 440-7372
Mailing address
2ND RECON BLDG A-71 CAMP LEJEUNE, FPO, AA 28547
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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