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Individual

MS. PAULA DELORES MALONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CST/RST, SA

Contact information

Practice address
3002 GILL ST, SUITE #3, BLOOMINGTON, IL 61704-3438
(309) 846-4716
Mailing address
706A RICKARD RD, SPRINGFIELD, IL 62704-1028
(217) 698-4361

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
246ZC0007X
IL

Other

Enumeration date
05/29/2008
Last updated
05/29/2008
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