Search › Arizona › 225700000X
Jeremiah Mack
NPI 1043807324 · on the registry since 2020 · sole proprietor
Practice
- Address
- 16410 S 12th St Apt 213
Phoenix, AZ 85048 - Phone
- (480) 765-0367
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-12-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona