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Individual

MR. ADRIAN MALLICOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPTA

Contact information

Practice address
5500 WILLIAMSBURG LANDING DR, WILLIAMSBURG, VA 23185
(757) 258-2178
Mailing address
1641 BIG BETHEL RD, HAMPTON, VA 23666-1412

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602797
VA

Other

Enumeration date
03/29/2010
Last updated
03/29/2010
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