Individual
TERESA PHILENE MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
4801 10TH ST, GREAT BEND, KS 67530-3542
(620) 792-7868
(620) 792-7867
Mailing address
4801 10TH ST, GREAT BEND, KS 67530-3252
(620) 792-7868
(620) 792-7867
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-00515
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002840C
—
KS
Enumeration date
06/28/2006
Last updated
03/09/2017
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