Individual
MRS. NICOLE C MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHLEBOTOMIST
Contact information
Practice address
1944 APPALOOSA MILL CIR, BUFORD, GA 30519-6616
(404) 518-8006
Mailing address
1944 APPALOOSA MILL CIR, BUFORD, GA 30519-6616
(404) 518-8006
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
753018
GA
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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