Individual
LUKE T MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
16658 N HIGHWAY 41, RATHDRUM, ID 83858-6890
(208) 687-9195
(208) 687-9750
Mailing address
16658 N HIGHWAY 41, RATHDRUM, ID 83858-6890
(208) 687-9195
(208) 687-9750
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT-8974
ID
Other
Enumeration date
02/19/2024
Last updated
02/27/2024
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