Organization
MALLARD EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER MALLARD OD (OWNER)
(615) 302-4477
Entity
Organization
Contact information
Practice address
1224 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3618
(931) 433-0906
(615) 250-4911
Mailing address
4959 MAIN ST, SPRING HILL, TN 37174-2727
(615) 302-4477
(615) 250-4911
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
09/20/2019
Last updated
01/23/2020
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