MALLORY KOULA

MISSOULA, MT
NPI1467987727
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: MT  MED-PHYS-LIC-114887)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: UT  10983218-1205)
Enumeration Date2017-04-25
Last Update Date2022-09-27
Business Address
MALLORY KOULA MD
3075 N RESERVE ST STE Q
MISSOULA, MT 59808-1390
Phone number: 406-327-1850
Mailing Address
MALLORY KOULA MD
PO BOX 12
LIBERTY LAKE, WA 99019-0012
Phone number: 406-327-1850