Individual
MALLORY BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3665 COTTON HILL RD, CUTHBERT, GA 39840-4919
(229) 881-4764
Mailing address
3665 COTTON HILL RD, CUTHBERT, GA 39840-4919
(229) 881-4764
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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