Individual
KENNETH VONDELL MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 SCHOOL ST SW STE 200, WASHINGTON, DC 20024-2774
(703) 752-8700
Mailing address
7402 FAWLEY AVE, FORT WASHINGTON, MD 20744-2124
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN58728
DC
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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