Individual
MALLORY HEINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
729 CLARK ST, TECUMSEH, MI 49286-1175
(231) 349-1044
Mailing address
729 CLARK ST, TECUMSEH, MI 49286-1175
(231) 349-1044
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703114226
MI
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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