Most Relevant Information
Provider Data
| NPI Number: | 1003575382 |
| Provider Name: | LAUREN MALLORY PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 5501020022 |
Most Important Dates
| Enumeration Date: | 12/14/2021 |
| Last Updated: | 12/14/2021 |
Provider Practice Location
235 WEALTHY ST SE
GRAND RAPIDS
MI
495035247
Practice Location Phone/Fax
| Phone: | 6168408000 |
| Fax: |
Provider Mailing Location
235 WEALTHY ST SE
GRAND RAPIDS
MI
495035247
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |