Individual
JOHNTAVIS LAMAR MALLARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1205 UNIVERSITY DR UNIT 112, BURLINGTON, NC 27215-8575
(336) 542-5111
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 702-4389
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P18256
NC
Other
Enumeration date
08/02/2018
Last updated
01/21/2026
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