Individual provider · Type 1 NPI

Mallory Moody Putnam, PA

Medical Physician Assistant · Lakeland, FL

NPI number 1336493428 Active

About NPI 1336493428

Mallory Moody Putnam, PA's National Provider Identifier is 1336493428, issued on Oct 29, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lakeland, FL. The record was last updated on Jan 30, 2017.