Provider Demographics
NPI:1952491300
Name:MACH, MARGARET ELAINE
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELAINE
Last Name:MACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KS
Mailing Address - Zip Code:67665-2540
Mailing Address - Country:US
Mailing Address - Phone:785-483-4222
Mailing Address - Fax:785-483-4222
Practice Address - Street 1:528 W 4TH ST
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-2540
Practice Address - Country:US
Practice Address - Phone:785-483-4222
Practice Address - Fax:785-483-4222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSK.S.A.75-3307B174400000X
KS174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist