person
Mackenzie Robert Fountain, DO
Student in an Organized Health Care Education/Training Program in Detroit, Michigan
NPI 1316520166

Mackenzie Robert Fountain is a Student in an Organized Health Care Education/Training Program based in Detroit, MI. Mackenzie Robert Fountain practices in Detroit, MI and has the professional credentials of DO. The NPI Number for Mackenzie Robert Fountain is 1316520166 and holds a License No. (Michigan).

The current practice location address for Mackenzie Robert Fountain is 3031 W Grand Blvd Ste 600, Detroit, MI and can be reached out via phone at 313-346-5235.

Location: 3031 W Grand Blvd Ste 600, Detroit, MI, 48202-3014
person
Provider Profile Details
NPI Number
1316520166
Provider Name
Mackenzie Robert Fountain
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
3031 W Grand Blvd Ste 600, Detroit, MI, 48202-3014
Phone Number
313-346-5235
Fax Number
Provider Enumeration Date
04/29/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3031 W Grand Blvd Ste 600
City
State
Zip
48202-3014
Phone Number
313-346-5235
Fax Number
person
Provider Business Mailing Address Details
Address
3031 W Grand Blvd Ste 600
City
State
Zip
48202-3014
Phone Number
313-346-5235
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
(Michigan)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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