Individual
DR. AMY ELIZABETH MALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
120 DEER RUN DR, DRESDEN, TN 38225-1837
(731) 364-5008
Mailing address
120 DEER RUN DR, DRESDEN, TN 38225-1837
(173) 136-4500
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH019636
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000025437
STATE LICENSE NUMBER
TN
01
—
013106
STATE LICENSE NUMBER
KY
Enumeration date
08/12/2005
Last updated
03/23/2010
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