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1215420724
AUDREY JEAN MALLON
SALT LAKE CITY, UT
NPI
1215420724
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: UT 10851651-2401)
Enumeration Date
2018-06-08
Last Update Date
2021-11-23
Business Address
AUDREY JEAN MALLON DPT
590 S WAKARA WAY
SALT LAKE CITY, UT 84108-1200
Phone number: 801-587-7109
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Mailing Address
AUDREY JEAN MALLON DPT
2725 S 700 E APT F
SALT LAKE CITY, UT 84106-2800
Phone number: 541-490-4450
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