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General NPI Number Information
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NPI Number | 1942040548
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Entity Type | Individual
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Provider Name | BRIANNA LYNN O'MALLEY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 334 S 13TH ST
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City | BURLINGTON
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State | CO
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Zip | 80807-2414
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Country | US
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Telephone | 719-346-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 2396 230TH PL SW
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City | BRIER
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State | WA
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Zip | 98036-8395
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Country | US
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Telephone | 425-346-5233
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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 | PT61561650
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License Number State | WA
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