Dr. Jaclyn Marie McKenzie, O.D.
Optometrist in Ann Arbor, MI. Individual provider (NPI-1).
NPI number1013210160
StatusActive
Last updated in NPPESDec 13, 2010
Details
- NPI
- 1013210160
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jaclyn Marie McKenzie
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 13, 2010
- Last updated
- Dec 13, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 4901004609 | MI | Yes |
Practice location
3601 Washtenaw AveAnn Arbor, MI 48104-5277
Phone 734-973-1712 · Fax 734-973-1712
Mailing address
5048 Pinewood DrBrighton, MI 48116-5132
Phone 810-923-4826
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