Individual
MS. MARY A HALLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1714 SW 17TH ST, OCALA, FL 34471-1227
(352) 509-9900
(844) 388-6186
Mailing address
1714 SW 17TH ST, OCALA, FL 34471-1227
(352) 509-9900
(844) 388-6186
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0229
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010176
—
NH
Enumeration date
06/12/2006
Last updated
08/11/2022
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