Individual
TAMIKA LYNN MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9916 COYLE ST, DETROIT, MI 48227-2411
(832) 708-8376
Mailing address
9916 COYLE ST, DETROIT, MI 48227-2411
(832) 708-8376
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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