MALLORY BOURG

BATON ROUGE, LA
NPI1164816831
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: LA  200789)
Enumeration Date2015-03-20
Last Update Date2023-09-29
Business Address
MALLORY BOURG
7777 HENNESSY BLVD SUITE 701
BATON ROUGE, LA 70808-4300
Phone number: 225-765-5864
Mailing Address
MALLORY BOURG
5959 S SHERWOOD FOREST BLVD
BATON ROUGE, LA 70816-6038
Phone number: 225-526-0006
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