Individual
ANYA ELIZABETH MALLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1975 AQUARENA SPRINGS DR APT 116, SAN MARCOS, TX 78666-8282
(517) 505-0734
Mailing address
1975 AQUARENA SPRINGS DR APT 116, SAN MARCOS, TX 78666-8282
(517) 505-0734
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000027276
TX
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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