Individual
RICHARD MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2714 WILMA RUDOLPH BLVD, CLARKSVILLE, TN 37040-5837
(931) 552-0796
Mailing address
1730 CRESTVIEW DR, CLARKSVILLE, TN 37042-4560
(931) 920-6456
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1705
LICENSE #
TN
Enumeration date
08/23/2006
Last updated
07/08/2007
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