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1780228171
MACKENSON LAFORTUNE
DACULA, GA
NPI
1780228171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
Additional Taxonomies
225200000X Physical Therapy Assistant
Enumeration Date
2019-10-29
Last Update Date
2021-09-28
Business Address
MACKENSON LAFORTUNE
1424 FILIGREE PL
DACULA, GA 30019
Phone number: 678-790-2882
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Mailing Address
MACKENSON LAFORTUNE
1424 FILIGREE PL
DACULA, GA 30019-7528
Phone number: 678-790-2882
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