Individual
MR. JAMES DANIEL MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEMORIAL DR, BRUCETON MILLS, WV 26525-9500
(304) 379-2114
Mailing address
104 BROOMSAGE RD, FAIRMONT, WV 26554-8730
(304) 282-3460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01304
WV
Other
Enumeration date
09/10/2007
Last updated
04/06/2022
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