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NPI Code Detail

MEDICARE: MOLLY A MALLORY

MEDICARE: MOLLY A MALLORY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1528732203
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY A MALLORY
Provider Business Mailing Address
First Line : 445 E DUBLIN GRANVILLE RD
Second Line :
City : WORTHINGTON
State : OH
Zip : 43085-3192
Country : US
Telephone Number : 614-844-3800
Fax Number :
Provider Business Practice Location Address
First Line : 1065 MEDINA RD
Second Line :
City : MEDINA
State : OH
Zip : 44256-5375
Country : US
Telephone Number : 614-844-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2021
Last Update Date : 08/05/2021

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Directions to “ MOLLY A MALLORY ” Practice Location

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