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MALLORY BROOKE SHREVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
405 CLAYTON ST, BENTON, IL 62812-1605
(618) 927-4070
Mailing address
405 CLAYTON ST, BENTON, IL 62812-1605
(618) 927-4070

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008886
IL

Other

Enumeration date
04/13/2022
Last updated
04/13/2022
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