Organization
MALLERS & SWOVERLAND ORTHOPAEDIC PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS MALLERS P.T. (THERAPIST/OWNER)
(260) 489-9887
Entity
Organization
Contact information
Practice address
9602 COLDWATER RD, SUITE 102, FORT WAYNE, IN 46825-2095
(260) 489-9887
(260) 489-9121
Mailing address
9602 COLDWATER RD, SUITE 102, FORT WAYNE, IN 46825-2095
(260) 489-9887
(260) 489-9121
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ8713
RR MEDICARE
IN
Enumeration date
11/23/2005
Last updated
08/01/2023
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