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General NPI Number Information
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NPI Number | 1497630792
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Entity Type | Individual
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Provider Name | MACKENZIE MAHONEY DPT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 9 HANNAFORD DR
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City | BUXTON
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State | ME
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Zip | 04093-6583
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Country | US
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Telephone | 207-815-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 515 STEVENS AVE UNIT 1
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City | PORTLAND
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State | ME
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Zip | 04103-2637
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Country | US
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Telephone | 508-341-2282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT7223
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License Number State | ME
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