Provider Demographics
NPI:1548839582
Name:AKERS, MARY MAKENZIE (PTA)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:MAKENZIE
Last Name:AKERS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S DAUGHERTY AVE
Mailing Address - Street 2:
Mailing Address - City:EASTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76448-2609
Mailing Address - Country:US
Mailing Address - Phone:254-631-5358
Mailing Address - Fax:254-631-0819
Practice Address - Street 1:304 S DAUGHERTY AVE
Practice Address - Street 2:
Practice Address - City:EASTLAND
Practice Address - State:TX
Practice Address - Zip Code:76448-2609
Practice Address - Country:US
Practice Address - Phone:254-631-5358
Practice Address - Fax:254-631-0819
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2154373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist