Individual
TIFFANY MALLOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 CONCOURSE PKWY STE 3000, ATLANTA, GA 30328-7106
(917) 500-9330
Mailing address
240 HALAH CIR, ATLANTA, GA 30328-5241
(917) 500-9330
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/15/2025
Last updated
02/15/2025
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