Individual
MR. BENITO NMN MALAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ORTHOTIST
Contact information
Practice address
100 EMANCIPATION DR, 590/121, HAMPTON, VA 23667-0001
(757) 722-9961
(757) 726-6076
Mailing address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
(757) 726-6076
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CO003796
VA
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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