Provider Demographics
NPI:1093953937
Name:MALONE, MICHAEL C (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:C
Last Name:MALONE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 LANDING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-8750
Mailing Address - Country:US
Mailing Address - Phone:828-310-2998
Mailing Address - Fax:828-396-5649
Practice Address - Street 1:5160 LANDING VIEW DR
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-8750
Practice Address - Country:US
Practice Address - Phone:828-310-2998
Practice Address - Fax:828-396-5649
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist