Individual
MALLORY B WARREN-BROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
608 OLD ROUTE 66, SAINT ROBERT, MO 65584-3730
(573) 336-5100
Mailing address
608 OLD ROUTE 66, SAINT ROBERT, MO 65584-3730
(573) 336-5100
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
588293
MO
363A00000X
Physician Assistant
Primary
2023011900
MO
Other
Enumeration date
01/18/2023
Last updated
03/31/2023
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