Individual
MISS ELLEN ANN MALLOY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
745 WASHINGTON ST, THAYER ACADEMY, BRAINTREE, MA 02184-5751
(781) 664-2273
Mailing address
86 JERUSALEM RD, COHASSET, MA 02025-1412
(781) 383-0686
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AH 95
MA
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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