Individual
MR. MELVIN MALLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T, P.T.A
Contact information
Practice address
3816 WATERSIDE DR, ORANGE PARK, FL 32073
(904) 802-1421
Mailing address
3816 WATERSIDE DR, ORANGE PARK, FL 32073-6982
(904) 802-1421
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2127861
TX
225200000X
Physical Therapy Assistant
Primary
PTA26759
FL
Other
Enumeration date
04/28/2010
Last updated
08/27/2018
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