Individual
MALCOLM N COLBERT III
Active
Individual
MALCOLM N COLBERT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12126
TN
2251X0800X
Orthopedic Physical Therapist
05010267A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00417209
MEDICARE RAILROAD PTAN
—
Enumeration date
07/22/2006
Last updated
12/06/2018
Update your record
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