Individual
MS. MALLORIE LLANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC, CES
Contact information
Practice address
130 CRISANTO AVE STE B, FORT MILL, SC 29715-6272
(803) 548-6464
Mailing address
130 CRISANTO AVE STE B, FORT MILL, SC 29715-6272
(803) 548-6464
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1570
SC
2255A2300X
Athletic Trainer
LAT-2634
NC
Other
Enumeration date
08/01/2014
Last updated
09/24/2024
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