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1639703812
ERIC NICHOLAS MACK
COLORADO SPRINGS, CO
NPI
1639703812
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: TX 433776)
Enumeration Date
2020-02-26
Last Update Date
2020-02-26
Business Address
ERIC NICHOLAS MACK OTR/L
6160 TUTT BLVD
COLORADO SPRINGS, CO 80923-3500
Phone number: 719-540-2150
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Mailing Address
ERIC NICHOLAS MACK OTR/L
4228 WINDING WAY CT
DALLAS, TX 75287-2767
Phone number: 802-558-6656
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