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1306248398
MACKENZIE MARIE CLARK
FORT WAYNE, IN
NPI
1306248398
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001685A)
Enumeration Date
2014-09-22
Last Update Date
2016-03-08
Business Address
-- MACKENZIE MARIE CLARK MS, LAT, ATC
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 812-598-7583
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Mailing Address
-- MACKENZIE MARIE CLARK MS, LAT, ATC
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 812-598-7583
Copy
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