Individual
MALLORY NABER MOSKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2273
(859) 301-6182
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-2273
(859) 301-6182
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004112
OH
363A00000X
Physician Assistant
Primary
PA1992
KY
Other
Enumeration date
03/05/2015
Last updated
04/02/2025
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