1700239233 NPI number — ANGIE MALONEE DOCTOR OF PHYSICAL T

Table of content: ANGIE MALONEE DOCTOR OF PHYSICAL T (NPI 1700239233)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700239233 NPI number — ANGIE MALONEE DOCTOR OF PHYSICAL T

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALONEE
Provider First Name:
ANGIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DOCTOR OF PHYSICAL T
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MALONEE
Provider Other First Name:
ANGIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700239233
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3848 HARROW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23831-7145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-524-0533
Provider Business Mailing Address Fax Number:
804-524-0133

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3848 HARROW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23831-7145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-955-0177
Provider Business Practice Location Address Fax Number:
804-524-0133
Provider Enumeration Date:
07/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305204813 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com