Mackenzie Ridley, PA

NPI #1053101378 in Provo, Utah

Provider Information

NPI Number: 1053101378
Entity Type: Individual
Name: Mackenzie Ridley, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: PA
Enumeration Date: May 9, 2025
Last Updated: May 9, 2025

Practice Location

Address: 1800 NOVELL PL
City: Provo
State: Utah
ZIP Code: 84606-6171
Phone: (801) 375-5125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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