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General NPI Number Information
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NPI Number | 1710086962
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Entity Type | Organization
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Legal Business Name | MALYS PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 77 NELSON ST SUITE 130
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City | AUBURN
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State | NY
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Zip | 13021-1941
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Country | US
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Telephone | 315-253-6891
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Fax | 315-255-0873
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Provider Business Mailing Address
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Address Line | 77 NELSON ST SUITE 130
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City | AUBURN
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State | NY
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Zip | 13021-1941
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Country | US
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Telephone | 315-253-6891
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Fax | 315-255-0873
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Authorized Official
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Title or Position | OWNER
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Name | MARK MALYS
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Credential |
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Telephone | 315-253-6891
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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 |
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License Number State |
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