Individual
LORALIE DIMACALI MALONZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 OLD SPRINGVILLE RD, SUITE 104, BIRMINGHAM, AL 35215
(800) 854-4589
(205) 520-0455
Mailing address
1920 OLD SPRINGVILLE ROAD, SUITE 104, BIRMINGHAM, AL 35215
(205) 520-9600
(205) 520-0455
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070.016201
IL
225100000X
Physical Therapist
Primary
2009032715
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WW0042880
PHILIPPINE PASSPORT NUMBER
—
Enumeration date
12/08/2009
Last updated
12/08/2009
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