Individual
MALLORY MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-8903
(954) 828-0425
Mailing address
1495 N PARK DR, WESTON, FL 33326-3215
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA21585
FL
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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