Individual
MALLARY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
157 BEAR PAW CT, BOGART, GA 30622-5183
(706) 372-1483
Mailing address
157 BEAR PAW CT, BOGART, GA 30622-5183
(706) 372-1483
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
LL000097
GA
163WM0102X
Maternal Newborn Registered Nurse
RN203578
GA
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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