Most Relevant Information
Provider Data
| NPI Number: | 1003533357 |
| Provider Name: | MALLORY SMITH NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 26148 |
Most Important Dates
| Enumeration Date: | 10/26/2022 |
| Last Updated: | 10/26/2022 |
Provider Practice Location
25 E CLARK ST
PINEWOOD
SC
291258989
Practice Location Phone/Fax
| Phone: | 8037744501 |
| Fax: |
Provider Mailing Location
25 E CLARK ST
PINEWOOD
SC
291258989
Provider Mailing Phone/Fax
| Phone: | 8037744501 |
| Fax: | 8034525712 |