MEDICARE: MACKENZIE LAUREN RICH RD

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
1	133V00000X	Registered Dietitian	11366993-4901	UT

General Provider Information

NPI Number	:	1851244123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE LAUREN RICH RD

Provider Business Mailing Address
First Line	:	10691 S OZARKS DR
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-5717
Country	:	US
Telephone Number	:	435-256-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	10691 S OZARKS DR
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-5717
Country	:	US
Telephone Number	:	435-256-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

Similar Medicare Providers

1689636839 — DR. JEAN CHU D.D.S.
Practice Location Address:

144 BRENTWOOD DR
SOUTH SAN FRANCISCO, CA
94080-5717

Practice Phone: 650-589-8988
Practice Fax: 650-351-7721

1427155969 — SUNSHINE EYE SERVICES
Practice Location Address:

200 SOUTH A STREET , SUITE 210
OXNARD, CA
93030-5717

Practice Phone: 805-483-4804
Practice Fax: 805-483-1304

1821188699 — JUDITH AGUILAR LIAO DDS
Practice Location Address:

128 BRENTWOOD DR
SOUTH SAN FRANCISCO, CA
94080-5717

Practice Phone: 650-757-6688
Practice Fax: 650-757-6556

1407903040 — DR. MARITE RIVERA CRUZ D.M.D.
Practice Location Address:

128 BRENTWOOD DR
SOUTH SAN FRANCISCO, CA
94080-5717

Practice Phone: 650-871-6303
Practice Fax: 650-871-4103

1285918383 — MR. LEE TODD LACKS LCPC-C, MT-BC
Practice Location Address:

9 LEMONT AVE
SOUTH PORTLAND, ME
04106-5717

Practice Phone: 207-210-6045
Practice Fax:

1801218854 — STASSNEY SMILES, P.C.
Practice Location Address:

5717 SOUTH IH 35 , BLDG B SUITE #101
AUSTIN, TX
78744

Practice Phone: 512-462-4775
Practice Fax: 512-462-4782

Directions to “ MACKENZIE LAUREN RICH RD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.