Individual
KEVIN MICHAEL O'MALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E. 66TH ST., SAVANNAH, GA 31405
(912) 604-4911
Mailing address
101 E 66TH ST, SAVANNAH, GA 31405-5212
(912) 604-4911
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
052438462
GA
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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