Individual
MR. KEITH BRUCE MALCHOFF JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
510 S ASH ST, YUMA, CO 80759-2704
(970) 630-0978
Mailing address
510 S ASH ST, YUMA, CO 80759-2704
(970) 630-0978
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1361
CO
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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