Individual
DAVID F MALLAVIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
420 N NAVAJO DR, PAGE, AZ 86040-0950
(928) 645-2772
(928) 645-9508
Mailing address
PO BOX 1806, PAGE, AZ 86040-1806
(928) 645-2772
(928) 645-9508
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1379
AZ
Other
Enumeration date
07/06/2006
Last updated
02/04/2020
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