Provider Demographics
NPI:1235538372
Name:NAFF, MALLORY (DPT)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:NAFF
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MALLORY
Other - Middle Name:
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1441 FLORIDA RD
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:KS
Mailing Address - Zip Code:66748-2229
Mailing Address - Country:US
Mailing Address - Phone:620-433-9898
Mailing Address - Fax:
Practice Address - Street 1:1441 FLORIDA RD
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:KS
Practice Address - Zip Code:66748-2229
Practice Address - Country:US
Practice Address - Phone:620-433-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist