Individual
MARY C LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BMBCH
Contact information
Practice address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Mailing address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42083
IA
Other
Enumeration date
06/16/2011
Last updated
11/06/2014
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