Mackenzie Dederich

NPI #1467185371 in Mukwonago, Wisconsin

Provider Information

NPI Number: 1467185371
Entity Type: Individual
Name: Mackenzie Dederich
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jul 7, 2022
Last Updated: Jul 7, 2022

Practice Location

Address: 214 S ROCHESTER ST
City: Mukwonago
State: Wisconsin
ZIP Code: 53149-1612
Phone: (262) 363-2220

Specialties & Taxonomy Codes

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

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