Individual
MALLORY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3430 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-5732
(228) 875-3318
Mailing address
530 MOCKINGBIRD DR, LONG BEACH, MS 39560-3100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1100
MS
Other
Enumeration date
05/22/2024
Last updated
09/03/2024
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