Individual
MS. MALLORY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 VETERANS AVE, BILOXI, MS 39531-2410
(555) 555-5555
Mailing address
400 VETERANS AVE, BILOXI, MS 39531-2410
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/04/2011
Last updated
07/26/2013
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