Individual
MS. MACKENZIE DIANE TEZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
12400 MELLOW MEADOW DR, AUSTIN, TX 78750-1824
(512) 994-8899
Mailing address
820 CAMINO VAQUERO PKWY APT 2303, AUSTIN, TX 78748-3305
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT9687
TX
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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