Healthcare Provider Details

I. General information

NPI: 1588583314
Provider Name (Legal Business Name): CLARE MACKIE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E DERENNE AVE
SAVANNAH GA
31405-6736
US

IV. Provider business mailing address

12705 GOLF CLUB DR
SAVANNAH GA
31419-2657
US

V. Phone/Fax

Practice location:
  • Phone: 912-644-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018443
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: