Provider Demographics
NPI:1043720212
Name:MACKAY-TIMMERMANS, DREW WILLIBRORD (ND)
Entity type:Individual
Prefix:DR
First Name:DREW
Middle Name:WILLIBRORD
Last Name:MACKAY-TIMMERMANS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:726 N GREENFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5062
Mailing Address - Country:US
Mailing Address - Phone:480-508-4226
Mailing Address - Fax:480-508-4356
Practice Address - Street 1:726 N GREENFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5062
Practice Address - Country:US
Practice Address - Phone:480-508-4226
Practice Address - Fax:480-508-4356
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17-1663175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath