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Individual

MALLORY B DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPH

Contact information

Practice address
901 SW GOODYEAR BLVD, LAWTON, OK 73505-9755
(580) 531-5858
Mailing address
901 SW GOODYEAR BLVD, LAWTON, OK 73505-9755

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9951
OK

Other

Enumeration date
03/08/2007
Last updated
07/08/2007
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