Individual
KATHRYN E MALOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4500 S WASHINGTON ST - ALTRU SPECIALTY CENTER, GRAND FORKS, ND 58201
(701) 780-7000
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1439
ND
225100000X
Physical Therapist
7037
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001L7MI
BCBS MINNESOTA
—
01
—
6403615
MEDICA
—
01
—
HP41184
HEALTHPARTNERS
—
Enumeration date
04/27/2006
Last updated
04/26/2019
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