Organization
MALLARD EYECARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONNIE MALLARD O.D. (PRESIDENT)
(205) 755-7114
Entity
Organization
Contact information
Practice address
1415 7TH ST S, CLANTON, AL 35045-3746
(205) 755-7114
Mailing address
826 SAVANNAH LN, CALERA, AL 35040-5553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009933443
—
AL
Enumeration date
05/26/2010
Last updated
05/26/2010
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