Gary Michael Mallow
Gary Michael Mallow is a Student in an Organized Health Care Education/Training Program in Augusta, Georgia. Registered with an NPI since 2021.
- In the registry since
- 2021
Practice location Address checks out
1120 15th StAugusta, GA 30912-0006
Phone: (954) 383-7454
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1659952323 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 15, 2021 |
| Last updated in NPPES | April 15, 2021 |
| Certification date | April 15, 2021 |
| Mailing address | 710 W 14th St Apt 317, Chicago, IL 60607-5101 |
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