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1598191918
AMBERLY MICHELE MALLON
FORT WAYNE, IN
NPI
1598191918
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36002180A)
Enumeration Date
2013-09-17
Last Update Date
2024-10-04
Business Address
Ms. AMBERLY MICHELE MALLON M.Ed, LAT, ATC
3946 ICE WAY
FORT WAYNE, IN 46805-1018
Phone number: 260-266-4007
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Mailing Address
Ms. AMBERLY MICHELE MALLON M.Ed, LAT, ATC
3946 ICE WAY
FORT WAYNE, IN 46805-1018
Phone number: 260-266-4007
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