Search › Pennsylvania › 163WC0200X
Michael Mack
NPI 1407138712 · on the registry since 2011 · sole proprietor
Practice
- Address
- 5416 N Lawrence St
Philadelphia, PA 19120 - Phone
- (267) 257-9270
Registry record
- Primary taxonomy
- 163WC0200X
163WC0200X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-09-13
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 Pennsylvania