Individual
KENNA MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2045 BROADWATER AVE STE 3, BILLINGS, MT 59102-4869
(406) 656-0950
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171-1185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-LIC-22272
MT
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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