| NPI | 1043523533 |
|---|---|
| Doing Business As | MACKENZIE PLACE FC |
| Entity Type | Organization |
| Authorized Contact | LAURA A CANTRELL Director Of Outpatient 360-901-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2012-02-20 |