Individual
DR. MALLORY ANN PROVINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2318 E 32ND ST, SUITE B, JOPLIN, MO 64804-4348
(417) 781-6300
Mailing address
2712 CORNING AVE, PARSONS, KS 67357-4008
(620) 778-2744
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2014013286
MO
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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