Heather L Mackenzie, PA | |
1340 Lake Blvd, Davis, CA 95616-5673 | |
(530) 753-5338 | |
(530) 759-7469 |
Full Name | Heather L Mackenzie |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 1340 Lake Blvd, Davis, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609971993 | NPI | - | NPPES |
PT0212400 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT21240 (California) | Primary |
Provider Name | Permanente Medical Group Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Heather L Mackenzie, PA Po Box 255228, Sacramento, CA 95865-5228 Ph: (800) 470-0071 | Heather L Mackenzie, PA 1340 Lake Blvd, Davis, CA 95616-5673 Ph: (530) 753-5338 |
Audrey Mott, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2035 Lyndell Ter Ste 200, Davis, CA 95616 Phone: 530-758-2222 | |
Alyssa Borchert, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1500 Shasta Dr Apt 135, Davis, CA 95616 Phone: 808-292-1051 | |
Daniel Martin, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3002 Ponteverde Ln, Davis, CA 95618 Phone: 530-758-1508 Fax: 530-758-1508 | |
Jolie Gonzalez, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2035 Lyndell Ter, Suite 200, Davis, CA 95616 Phone: 530-758-2222 | |
Dr. Leigh Quill, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1340 Lake Blvd, Davis, CA 95616 Phone: 530-753-5338 Fax: 530-753-4609 | |
Jennifer Ferguson Rhoads, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1340 Lake Blvd, Davis, CA 95616 Phone: 530-753-5338 Fax: 530-753-4609 | |
Edward T. Barakatt, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1340 Lake Blvd, Davis, CA 95616 Phone: 530-753-5338 Fax: 530-753-4609 |