Individual
STACY MALIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 OLD TUSTIN AVE, SANTA ANA, CA 92705-7810
(310) 701-5930
Mailing address
1800 OLD TUSTIN AVE, SANTA ANA, CA 92705-7810
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10285
CA
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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