The holder whose full name is Mack, Kenneth J.,come from Granger IN,hold the Phys Ther Assistant license(NO.06003673A) which status is Active.
| Name | Mack, Kenneth J. |
|---|---|
| License Number | 06003673A |
| License Type | Phys Ther Assistant |
| License Status | Active |
| City | Granger |
| State | IN |