Individual
KIMBERLY MALAVOLTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2298
(779) 696-2093
Mailing address
122 N CENTER ST, ROCKTON, IL 61072-2302
(815) 980-8550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/06/2021
Last updated
01/06/2021
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