Individual
COLLEEN MARIE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 S GRANT AVE STE 350, COLUMBUS, OH 43215-4701
(614) 566-9550
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.008234RX
OH
Other
Enumeration date
09/13/2018
Last updated
10/06/2023
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