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1114195476
MALLORY A WILSON
BIRMINGHAM, AL
NPI
1114195476
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-100306)
Enumeration Date
2008-02-20
Last Update Date
2008-06-04
Business Address
-- MALLORY A WILSON CRNA
1201 11TH AVE S
BIRMINGHAM, AL 35205-3410
Phone number: 205-930-7296
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Mailing Address
-- MALLORY A WILSON CRNA
PO BOX 55905
BIRMINGHAM, AL 35255-5905
Phone number: 205-930-7296
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