Provider Demographics
NPI:1376733733
Name:MALITO, SHERRY H (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:H
Last Name:MALITO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-5413
Mailing Address - Country:US
Mailing Address - Phone:270-737-1665
Mailing Address - Fax:
Practice Address - Street 1:711 SPRUCE LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-5413
Practice Address - Country:US
Practice Address - Phone:270-737-1665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist