Most Relevant Information
Provider Data
| NPI Number: | 1003315276 |
| Provider Name: | MACKENZIE ANN STUCKER TC.A.D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 324500000X |
| Specialty: | Substance Abuse Rehabilitation Facility |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/02/2018 |
| Last Updated: | 02/02/2018 |
Provider Practice Location
2030 KEOKUK ST
IOWA CITY
IA
522404456
Practice Location Phone/Fax
| Phone: | 3193519760 |
| Fax: | 3193519760 |
Provider Mailing Location
2030 KEOKUK ST
IOWA CITY
IA
522404456
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |