Individual
AMY KNISS MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
401 MAIN STREET, LAKE VILLAGE, AR 71653
(870) 265-2220
Mailing address
401 MAIN STREET, LAKE VILLAGE, AR 71653
(870) 265-2220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD12025
AR
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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