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Mackenzie Dederich
Student in an Organized Health Care Education/Training Program in Mukwonago, Wisconsin
NPI 1467185371

Mackenzie Dederich is a Student in an Organized Health Care Education/Training Program based in West Allis, WI. Mackenzie Dederich practices in Mukwonago, WI. The NPI Number for Mackenzie Dederich is 1467185371 and holds a License No. (Wisconsin).

The current practice location address for Mackenzie Dederich is 214 S Rochester St, Mukwonago, WI and can be reached out via phone at 262-363-2220.

Location: 214 S Rochester St, Mukwonago, WI, 53214-5073
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467185371
Provider Name
Mackenzie Dederich
Credential
Provider Entity Type
Individual
Gender
Male
Address
214 S Rochester St, Mukwonago, WI, 53214-5073
Phone Number
262-363-2220
Fax Number
Provider Enumeration Date
07/07/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
214 S Rochester St
City
Mukwonago
State
Wisconsin
Zip
53149-1612
Phone Number
262-363-2220
Fax Number
person
Provider Business Mailing Address Details
Address
214 S Rochester St
City
Mukwonago
State
Wisconsin
Zip
53149-1612
Phone Number
262-363-2220
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
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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