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Individual

JOHN MALLOY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.T.

Contact information

Practice address
185 WOODY CIRCLE, TRYON, NC 28782
(828) 894-0476
(828) 894-6588
Mailing address
185 WOODY CIRCLE, TRYON, NC 28782
(828) 894-0476
(828) 894-6588

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3740
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7301806
NC
Enumeration date
09/14/2006
Last updated
07/08/2007
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