Basic Information
| Provider Information | |||||||||
| NPI: | 1720656697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUFF | ||||||||
| FirstName: | MACKENZIE | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1585 MID VALLEY DR STE 3 | ||||||||
| Address2: | |||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804879099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708798026 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1585 MID VALLEY DR STE 3 | ||||||||
| Address2: | |||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804879099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708798026 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2021 | ||||||||
| LastUpdateDate: | 06/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 0017722 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.