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Individual

TYLER MALLORY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPS,CHW-C

Contact information

Practice address
105 S WEBER AVE, SALISBURY, MO 65281-1071
(660) 338-5001
Mailing address
102 W HILL ST, HUNTSVILLE, MO 65259-1197
(660) 651-9102

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
17723
MO

Other

Enumeration date
03/12/2025
Last updated
03/12/2025
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