Individual
DIVYA MALLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1750 112TH AVE NE, BLDG 4, STE E175, BELLEVUE, WA 98004-3752
(425) 289-0381
(425) 239-0387
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009837
WA
Other
Enumeration date
03/22/2006
Last updated
03/24/2017
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