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Individual

ISAAC JOHN MALONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1615 CURLEW DR, AMMON, ID 83406-4718
(208) 516-1204
Mailing address
169 N GATEWAY DR STE 160, PROVIDENCE, UT 84332-9882
(435) 799-3111

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
225100000X
Physical Therapist
Primary
PT-8842
ID
225100000X
Physical Therapist
UT

Other

Enumeration date
11/29/2016
Last updated
08/02/2023
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