Mack, Dywana Carolyn

Mack, Dywana Carolyn is an individual health care provider with primary practice located at 1 Civic Plaza Dr Suite 625, Carson CA 90745-2243. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Mack, Dywana Carolyn can be contacted via phone (310) 549-4500.

Contact Information

Primary practice address
1 Civic Plaza Dr Suite 625 Carson CA 90745-2243
Phone: (310) 549-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X AT 3079 California

Profile Details

NPI number 1538375167
LBN Legal business name Mack, Dywana Carolyn
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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