Individual
MRS. MARY ANNA MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 CRESTWOOD DR, MOUNTAIN BRK, AL 35213-3108
(205) 870-1099
Mailing address
105 CRESTWOOD DRIVE, BIRMINGHAM, AL 35213-3108
(205) 870-1099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTH-4554
AL
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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