Individual
BONNIE E MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1415 7TH ST S, CLANTON, AL 35045-3746
(205) 755-7114
(205) 755-8142
Mailing address
826 SAVANNAH LN, CALERA, AL 35040-5553
(205) 835-1320
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-BO9-TA-693
AL
Other
Enumeration date
08/25/2005
Last updated
08/06/2007
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