Individual
MRS. KARLI WENTWORTH MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6 W NEWPORT RD, LITITZ, PA 17543-7774
(717) 725-2849
Mailing address
6 W NEWPORT RD, LITITZ, PA 17543-7774
(717) 725-2849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054553
PA
Other
Enumeration date
09/12/2010
Last updated
11/19/2010
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