Individual
ANDREW MALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
273 FRONT ST, ATCO, NJ 08004-1958
(856) 237-4703
Mailing address
273 FRONT ST, ATCO, NJ 08004-1958
(856) 237-4703
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA01559600
NJ
225100000X
Physical Therapist
40QA01559600
NJ
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
08/12/2014
Last updated
10/10/2017
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