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NPI Code Detail

MEDICARE: GENEVIEVE OLDS GOOD-MALLOY DPT

MEDICARE: GENEVIEVE OLDS GOOD-MALLOY DPT
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
1225100000XPhysical Therapist23480MD

General Provider Information

NPI Number : 1720389539
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENEVIEVE OLDS GOOD-MALLOY DPT
Provider Business Mailing Address
First Line : 6707 DEMOCRACY BLVD STE 504
Second Line :
City : BETHESDA
State : MD
Zip : 20817-1166
Country : US
Telephone Number : 301-637-8712
Fax Number : 410-290-4488
Provider Business Practice Location Address
First Line : 6707 DEMOCRACY BLVD STE 504
Second Line :
City : BETHESDA
State : MD
Zip : 20817-1166
Country : US
Telephone Number : 301-637-8712
Fax Number : 410-290-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2010
Last Update Date : 12/08/2023

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Directions to “ GENEVIEVE OLDS GOOD-MALLOY DPT” Practice Location

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