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Individual

MALINDA K RILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
415 CROSSLAKE DR, EVANSVILLE, IN 47715-8263
(812) 476-0409
(812) 476-1016
Mailing address
PO BOX 5629, EVANSVILLE, IN 47716-5629
(812) 759-7451
(812) 759-7482

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005971
KY
225100000X
Physical Therapist
05008665A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000714667
BLUE CROSS BLUE SHIELD
IN
01
000000725882
BLUE CROSS BLUE SHIELD
IN
01
000000808883
BLUE CROSS BLUE SHIELD
KY
05
201020130
IN
Enumeration date
08/27/2009
Last updated
02/17/2020
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