Individual
T L MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
401 EAST A STREET, OGALLALA, NE 69153-2123
(308) 284-4194
Mailing address
401 EAST A STREET, OGALLALA, NE 69153-2123
(308) 284-4194
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
684
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06871
BC/BS OF NE.
NE
05
—
47045806700
—
NE
Enumeration date
01/16/2007
Last updated
10/15/2007
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