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Individual

MS. MAKENZIE BRYNN DUNCAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3018 YARGERVILLE RD, LA SALLE, MI 48145-9792
(419) 350-9678
Mailing address
462 E 10TH ST, INDIANAPOLIS, IN 46202-4600
(419) 350-9678

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003146A
IN
363AM0700X
Medical Physician Assistant
10003146A
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/17/2020
Last updated
09/16/2022
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