Search › Montana › 207Q00000X
Mallory Koula, MD
NPI 1467987727 · on the registry since 2017 · sole proprietor
Practice
- Address
- 3075 N Reserve St Ste Q
Missoula, MT 59808 - Phone
- (406) 327-1850
- Fax
- (406) 327-1875
- Organisation at this address
- Shoptikal Llc
Providence Health & Services Mt
Providence Health & Services MtInferred from a shared address, not stated in the registry. - Clinicians at this address
- 17
Additional practice sites
- 30 N 1900 E Rm 1a071, Salt Lake City, UT
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 2085R0202X
- Licence states on file
- UT, MT
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-09-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Montana