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Individual

MARISSA MALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
408 19TH ST NW, ROCHESTER, MN 55901-8126
(512) 869-9638
Mailing address
408 19TH ST NW, ROCHESTER, MN 55901-8126
(512) 869-9638

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Enumeration date
10/08/2019
Last updated
10/08/2019
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