Mackenzie Hansen

NPI #1265984017 in Fox Lake, Illinois

Provider Information

NPI Number: 1265984017
Entity Type: Individual
Name: Mackenzie Hansen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Oct 27, 2016
Last Updated: Oct 27, 2016

Practice Location

Address: 37 RUSHMORE RD
City: Fox Lake
State: Illinois
ZIP Code: 60020-1623
Phone: (224) 213-4503

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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