MACKENSON LAFORTUNE

DACULA, GA
NPI1780228171
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
Additional Taxonomies225200000X Physical Therapy Assistant
Enumeration Date2019-10-29
Last Update Date2021-09-28
Business Address
MACKENSON LAFORTUNE
1424 FILIGREE PL
DACULA, GA 30019
Phone number: 678-790-2882
Mailing Address
MACKENSON LAFORTUNE
1424 FILIGREE PL
DACULA, GA 30019-7528
Phone number: 678-790-2882