MEDICARE: MIRANDA DAWN MALONE LE, LTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Z00000X	Other Specialist/Technologist	2024010331	MO

General Provider Information

NPI Number	:	1548020134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA DAWN MALONE LE, LTA

Provider Business Mailing Address
First Line	:	1055 E TERRA LN
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2750
Country	:	US
Telephone Number	:	636-487-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 E TERRA LN
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2750
Country	:	US
Telephone Number	:	636-487-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	03/20/2024

Similar Medicare Providers

1427901594 — MISSOURI COMMUNITY ADVANCEMENT NETWORK
Practice Location Address:

1043 E TERRA LN
O FALLON, MO
63366-2750

Practice Phone: 931-434-3358
Practice Fax: 636-754-0643

1861481558 — DR. JOHN FRANK ANZALONE DO
Practice Location Address:

1055 E TERRA LN
O FALLON, MO
63366-2750

Practice Phone: 636-272-6161
Practice Fax: 636-240-9188

1326057407 — DR. THOMAS GEORGE WHITE JR. D.D.S.
Practice Location Address:

1043 E TERRA LN
O FALLON, MO
63366-2750

Practice Phone: 636-240-7606
Practice Fax: 636-240-8343

1740162585 — BRIANNE STEVICH
Practice Location Address:

1055 E TERRA LN
O FALLON, MO
63366-2750

Practice Phone: 636-578-3501
Practice Fax:

1154298040 — THE ARCH ADVOCATE INC
Practice Location Address:

1043 E TERRA LN
O FALLON, MO
63366-2750

Practice Phone: 931-434-3358
Practice Fax:

1194798231 — ROBERTSON & KOENIG LTD
Practice Location Address:

65 N TAYLOR ST
FALLON, NV
89406-2750

Practice Phone: 775-423-8024
Practice Fax: 775-423-8593

Directions to “ MIRANDA DAWN MALONE LE, LTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.