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1699149906
MALLORY LAKE MCCOY
RALEIGH, NC
NPI
1699149906
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-06072)
Enumeration Date
2015-11-24
Last Update Date
2023-05-24
Business Address
MALLORY LAKE MCCOY PA-C
4601 LAKE BOONE TRL STE 1B
RALEIGH, NC 27607-7503
Phone number: 919-781-1800
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Mailing Address
MALLORY LAKE MCCOY PA-C
4601 LAKE BOONE TRL STE 1B
RALEIGH, NC 27607-7503
Phone number: 919-781-1800
Copy
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