Mary Kim Qualls, MSORT/L

NPI #1124251178 in Nebo, Kentucky

Provider Information

NPI Number: 1124251178
Entity Type: Individual
Name: Mary Kim Qualls, MSORT/L
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MSORT/L
Enumeration Date: Aug 25, 2009
Last Updated: Aug 25, 2009

Practice Location

Address: 300 DONALDSON RD
City: Nebo
State: Kentucky
ZIP Code: 42441-9339
Phone: (270) 249-3910

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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