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1407547326
JAYA PRAKASH MALLELA
STILLWATER, OK
NPI
1407547326
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-05-19
Last Update Date
2023-05-19
Business Address
Dr. JAYA PRAKASH MALLELA
1323 W 6TH AVE
STILLWATER, OK 74074-4306
Phone number: 405-372-1480
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Mailing Address
Dr. JAYA PRAKASH MALLELA
4700 KAMRAN CT
EDMOND, OK 73013-9040
Phone number:
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