Individual
MR. CEDRIC MALONE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 EMMAUS CIR, ELIZABETHTOWN, KY 42701-4416
(270) 900-1277
Mailing address
330 EMMAUS CIR, ELIZABETHTOWN, KY 42701-4416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213108
TX
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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