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NPI Code Detail

MEDICARE: DEANNA MACKENZIE

MEDICARE: DEANNA MACKENZIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantMI
2225200000XPhysical Therapy Assistant5502001435MI

General Provider Information

NPI Number : 1407330814
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA MACKENZIE
Provider Business Mailing Address
First Line : 800 S 38TH ST UNIT 15
Second Line :
City : ESCANABA
State : MI
Zip : 49829-4347
Country : US
Telephone Number : 906-367-1471
Fax Number :
Provider Business Practice Location Address
First Line : 2525 7TH AVE S
Second Line :
City : ESCANABA
State : MI
Zip : 49829-1131
Country : US
Telephone Number : 906-786-0408
Fax Number : 906-233-0095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2018
Last Update Date : 02/19/2025

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Directions to “ DEANNA MACKENZIE ” Practice Location

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