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Individual

KEVIN JAMES MALLOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
456 SW MONROE AVE, CORVALLIS, OR 97333-4781
(541) 791-3411
Mailing address
456 SW MONROE AVE, CORVALLIS, OR 97333-4781
(541) 791-3411

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
03/10/2020
Last updated
03/10/2020
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