Provider Demographics
NPI:1215220652
Name:MALMBERG, HILLARY ELIZABETH (ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:HILLARY
Middle Name:ELIZABETH
Last Name:MALMBERG
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 MONTLIEU AVE
Mailing Address - Street 2:DRAWER 9
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4221
Mailing Address - Country:US
Mailing Address - Phone:336-841-4544
Mailing Address - Fax:
Practice Address - Street 1:833 MONTLIEU AVE
Practice Address - Street 2:DRAWER 9
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4221
Practice Address - Country:US
Practice Address - Phone:336-841-4544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer