Individual
MARK MALYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
2005 CANDLEWYCK DR, CHARLOTTESVILLE, VA 22901-9426
(434) 979-0987
Mailing address
2005 CANDLEWYCK DR, CHARLOTTESVILLE, VA 22901-9426
(434) 979-0987
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119001055
VA
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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