Individual
OMAR MALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
29474 7 MILE RD, LIVONIA, MI 48152-1986
(248) 615-2815
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005689
MI
Other
Enumeration date
06/26/2023
Last updated
03/05/2024
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