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General NPI Number Information
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NPI Number | 1720905037
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Entity Type | Individual
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Provider Name | KRISTIN MARIE MACKENZIE PTA
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Gender | Female
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 95 WYMAN RD
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City | KEENE
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State | NH
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Zip | 03431-5031
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Country | US
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Telephone | 877-381-3360
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Fax |
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Provider Business Mailing Address
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Address Line | 5 LORD VIEW DR
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City | JAFFREY
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State | NH
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Zip | 03452-5532
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Country | US
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Telephone | 508-353-2683
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1531
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License Number State | NH
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