Provider Demographics
NPI:1215475280
Name:MACKEY, RHEALEE A
Entity type:Individual
Prefix:
First Name:RHEALEE
Middle Name:A
Last Name:MACKEY
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 1:600 S DOBSON RD
Mailing Address - Street 2:UNIT 166
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-1811
Mailing Address - Country:US
Mailing Address - Phone:480-606-2093
Mailing Address - Fax:
Practice Address - Street 1:600 S DOBSON RD
Practice Address - Street 2:UNIT 166
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-1811
Practice Address - Country:US
Practice Address - Phone:480-606-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT05326P172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZMT05326POtherLMT