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Individual

CHATITY M MALLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
176 CHRISTOPHER CIR, FORT VALLEY, GA 31030-8403
(478) 501-3805
Mailing address
176 CHRISTOPHER CIR, FORT VALLEY, GA 31030-8403
(478) 501-3805

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
08/09/2021
Last updated
08/09/2021
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