Dave Mack is a Military Health Care Provider based in Madison, WI. Dave Mack practices in Madison, WI. The NPI Number for Dave Mack is 1376648154 and holds a License No. NA (Wisconsin).
The current practice location address for Dave Mack is 1514 Drake St., Madison, WI and can be reached out via phone at 608-294-9922.
Location: 1514 Drake St., Madison, WI, 53711
Provider Profile Details
NPI Number
1376648154
Provider Name
Dave Mack
Credential
Provider Entity Type
Individual
Gender
Male
Address
1514 Drake St., Madison, WI, 53711
Phone Number
608-294-9922
Fax Number
Provider Enumeration Date
09/14/2006
Last Update Date
03/08/2024
Provider Business Practice Location Address Details
Address
1514 Drake St.
City
State
Zip
53711
Phone Number
608-294-9922
Fax Number
Provider Business Mailing Address Details
Address
1514 Drake St.
City
State
Zip
53711
Phone Number
608-294-9922
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
License No.
NA (Wisconsin)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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