Healthcare Provider Details

I. General information

NPI: 1225751266
Provider Name (Legal Business Name): MACKENZIE STROUT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MACKENZIE HESS

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N COLLEGE ST
MOUNTAIN HOME AR
72653-3653
US

IV. Provider business mailing address

209 S KINGSWOOD DR
MOUNTAIN HOME AR
72653-4153
US

V. Phone/Fax

Practice location:
  • Phone: 870-701-5089
  • Fax: 870-277-0896
Mailing address:
  • Phone: 870-701-5089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT028916
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4882
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: