Keith A. Mallatt Od

NPI #1831379163 in Pittsburg, Kansas

Provider Information

NPI Number: 1831379163
Entity Type: Organization
Organization Name: Keith A. Mallatt Od
Primary Specialty: Eyewear Supplier
Enumeration Date: Nov 3, 2007
Last Updated: Apr 20, 2010

Practice Location

Address: 301 N BROADWAY ST
City: Pittsburg
State: Kansas
ZIP Code: 66762-4806
Phone: (620) 231-1720

Authorized Official

Name: DR. KEITH ALLEN MALLATT, O.D.
Title: OWNER
Phone: (620) 231-1720

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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