Individual
SIEDYRIA MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2052 POST OAK CT, MOBILE, AL 36695-7300
(256) 345-3317
Mailing address
2052 POST OAK CT, MOBILE, AL 36695-7300
(256) 345-3317
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2060
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/26/2021
Last updated
12/01/2022
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