Individual
ANNIE MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1256 W BOUGHTON RD, BOLINGBROOK, IL 60440-6568
(630) 378-9420
Mailing address
1256 W BOUGHTON RD, BOLINGBROOK, IL 60440-6568
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013821
IL
Other
Enumeration date
02/09/2007
Last updated
11/12/2008
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