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Individual

MALLORI SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1501 W 7TH ST STE 2, CHANUTE, KS 66720-2516
(620) 432-5588
(620) 431-1192
Mailing address
PO BOX 426, CHANUTE, KS 66720-0426
(620) 432-5588
(620) 431-1192

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02021
KS

Other

Enumeration date
08/31/2017
Last updated
08/23/2023
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