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General NPI Number Information
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NPI Number | 1164187985
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Entity Type | Individual
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Provider Name | KIARA JANESE MALONE DPT, PT, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 511 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-3230
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Country | US
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Telephone | 215-923-6031
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Fax |
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Provider Business Mailing Address
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Address Line | 1044 SIERRA GORDA DR
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City | GALLATIN
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State | TN
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Zip | 37066-4556
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Country | US
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Telephone | 423-580-6714
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14719
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3025
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT008356
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT032259
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License Number State | PA
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