Individual
JADA MCDONALD O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM
Contact information
Practice address
1140 SHIPYARD BLVD, WILMINGTON, NC 28412-6439
(910) 332-0179
(910) 332-0671
Mailing address
1140 SHIPYARD BLVD, WILMINGTON, NC 28412-6439
(910) 332-0179
(910) 332-0671
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM02960
NC
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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