Individual
MARCUS MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
700 N PROVIDENCE RD, COLUMBIA, MO 65203-4373
(573) 442-0194
(573) 443-8253
Mailing address
811 E GREEN MEADOWS RD APT 210, COLUMBIA, MO 65201-3747
(573) 205-6145
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2021031841
MO
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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