Individual
MALLORY MOZLEY NOTTENKAMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
188 HOSPITAL DR STE 202, FAIRHOPE, AL 36532-2038
(251) 990-1922
Mailing address
12626 DOMINION DR, FAIRHOPE, AL 36532-7704
(251) 228-2389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
PA-1386
AL
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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