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1003699240
BARBARA MALLORY LANE
VALDOSTA, GA
NPI
1003699240
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207NS0135X Dermatology, Procedural Dermatology
(Licence: GA RN203145)
Enumeration Date
2023-08-14
Last Update Date
2023-10-26
Business Address
BARBARA MALLORY LANE NP
4233 CAMELOT CROSSING
VALDOSTA, GA 31602-6926
Phone number: 229-469-4383
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Mailing Address
BARBARA MALLORY LANE NP
4233 CAMELOT CROSSING
VALDOSTA, GA 31602-6926
Phone number: 229-469-4383
Copy
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