Individual
MALLORY MAE LEANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 E FLORIDA AVE, APPLETON, WI 54911-1325
(920) 731-7310
(920) 733-3050
Mailing address
325 E FLORIDA AVE, APPLETON, WI 54911-1325
(920) 731-7310
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2376-19
WI
Other
Enumeration date
10/14/2015
Last updated
11/04/2024
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