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General NPI Number Information
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NPI Number | 1366675100
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Entity Type | Individual
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Provider Name | MALINDA K RILEY MPT
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Gender | Female
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 415 CROSSLAKE DR
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City | EVANSVILLE
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State | IN
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Zip | 47715-8263
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Country | US
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Telephone | 812-476-0409
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Fax | 812-476-1016
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Provider Business Mailing Address
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Address Line | PO BOX 5629
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City | EVANSVILLE
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State | IN
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Zip | 47716-5629
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Country | US
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Telephone | 812-759-7451
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Fax | 812-759-7482
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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 | 05008665A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 005971
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License Number State | KY
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