Individual
MALLORY BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1218 KANSAS ST, DOWNS, KS 67437-1404
(785) 454-3378
Mailing address
1218 KANSAS ST, DOWNS, KS 67437-1404
(785) 454-3378
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02289
KS
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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