Most Relevant Information
Provider Data
| NPI Number: | 1003301557 |
| Provider Name: | MACKENZIE DICKINSON DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 5101024245 |
Most Important Dates
| Enumeration Date: | 06/27/2018 |
| Last Updated: | 07/01/2021 |
Provider Practice Location
3955 PATIENT CARE DR STE A
LANSING
MI
489114271
Practice Location Phone/Fax
| Phone: | 5173747600 |
| Fax: | 8554955457 |
Provider Mailing Location
3955 PATIENT CARE DR STE A
LANSING
MI
489114271
Provider Mailing Phone/Fax
| Phone: | 5173747600 |
| Fax: | 8554955457 |