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1356950752
JORDAN MALLERY
FARGO, ND
NPI
1356950752
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: ND RL16719)
Enumeration Date
2020-07-31
Last Update Date
2020-07-31
Business Address
JORDAN MALLERY MD
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-234-5933
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Mailing Address
JORDAN MALLERY MD
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-234-5933
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