Individual
MS. LARAINE ANN MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
160 SW AIRVIEW AVE, PORT SAINT LUCIE, FL 34984-4901
(772) 340-1837
Mailing address
160 SW AIRVIEW AVE, PORT SAINT LUCIE, FL 34984-4901
(772) 340-1837
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19159
FL
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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