Individual
MALLORY BOACKLE TASSEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7191 CAHABA VALLEY RD STE 102, HOOVER, AL 35242-6507
(205) 408-6600
Mailing address
1130 22ND ST S STE 1000, BIRMINGHAM, AL 35205-2881
(205) 408-6600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH8787
AL
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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