Provider Demographics
NPI:1467473082
Name:PAMER, MACKENZIE B (DC)
Entity Type:Individual
Prefix:MISS
First Name:MACKENZIE
Middle Name:B
Last Name:PAMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 W OLENTANGY ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8434
Mailing Address - Country:US
Mailing Address - Phone:614-798-1419
Mailing Address - Fax:614-798-1430
Practice Address - Street 1:246 W OLENTANGY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8434
Practice Address - Country:US
Practice Address - Phone:614-798-1419
Practice Address - Fax:614-798-1430
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor