Individual
ROGER MALLINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9405 HIGHWAY 17 BYP, MURRELLS INLET, SC 29576-9301
(843) 650-2213
Mailing address
178 GRAYTWIG CIR, MURRELLS INLET, SC 29576-6466
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2602
SC
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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