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1821514563
MALLORY POLIVKA
DULUTH, MN
NPI
1821514563
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2017-08-15
Last Update Date
2018-08-20
Business Address
MALLORY POLIVKA M.A., R-DMT
101 W 2ND ST
DULUTH, MN 55802
Phone number: 218-724-3122
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Mailing Address
MALLORY POLIVKA M.A., R-DMT
211 MORLEY PKWY
DULUTH, MN 55803-2127
Phone number:
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