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1780125278
MALLORY R. WALTRIP
SPRINGFIELD, IL
NPI
1780125278
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Former Name
MALLORY RAHAR
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: IL 209015762)
Enumeration Date
2017-03-16
Last Update Date
2024-01-19
Business Address
MALLORY R. WALTRIP APRN
900 N 1ST ST
SPRINGFIELD, IL 62702-3749
Phone number: 217-528-7541
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Mailing Address
MALLORY R. WALTRIP APRN
1025 S 6TH ST
SPRINGFIELD, IL 62703-2403
Phone number: 217-528-7541
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