Individual
KIRSTEN LEIGH MALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1220 AZALEA RD, MOBILE, AL 36693-2859
(251) 607-6495
Mailing address
8685 MAGNOLIA LN E, IRVINGTON, AL 36544-6036
(251) 644-4008
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
55033
AL
Other
Enumeration date
02/07/2021
Last updated
02/07/2021
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