Individual
SUSAN MORTON MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 N LOTTIE AVE, OKLAHOMA CITY, OK 73117-2051
(405) 600-3103
(405) 605-8120
Mailing address
2029 S COUNTY LINE AVE, BLANCHARD, OK 73010-9454
(405) 922-6587
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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