Individual
MALLORY ELIZABETH BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
309 S GASKINS RD, RICHMOND, VA 23238-5707
(804) 380-6162
Mailing address
309 S GASKINS RD, RICHMOND, VA 23238-5707
(804) 380-6162
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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