MEDICARE: MRS. DONNA MALONEY P.T.

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
1	225100000X	Physical Therapist	2590	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790754604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA MALONEY P.T.

Provider Business Mailing Address
First Line	:	8235 KIRK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-1900
Country	:	US
Telephone Number	:	719-494-8348
Fax Number	:	719-494-8348

Provider Business Practice Location Address
First Line	:	8235 KIRK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-1900
Country	:	US
Telephone Number	:	719-494-8348
Fax Number	:	719-494-8348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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