JOHNTAVIS LAMAR MALLARY

FAYETTEVILLE, NC
NPI1932687886
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: NC  P18256)
Enumeration Date2018-08-02
Last Update Date2025-09-12
Business Address
-- JOHNTAVIS LAMAR MALLARY PT
1991 FORDHAM DR STE 102
FAYETTEVILLE, NC 28304-3774
Phone number: 910-484-4653
Mailing Address
-- JOHNTAVIS LAMAR MALLARY PT
625 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546-2395
Phone number:
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