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General NPI Number Information
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NPI Number | 1699621425
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Entity Type | Individual
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Provider Name | MALLORY PARRISH PTA
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Gender | Female
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 88191 HIGHWAY 9
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City | LINEVILLE
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State | AL
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Zip | 36266-6966
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Country | US
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Telephone | 256-396-3250
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Fax | 256-269-6158
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Provider Business Mailing Address
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Address Line | 88191 HIGHWAY 9
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City | LINEVILLE
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State | AL
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Zip | 36266-6966
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Country | US
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Telephone | 256-396-3250
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Fax | 256-269-6158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA12570
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License Number State | AL
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