Provider Demographics
NPI:1437571155
Name:MALONE, NEASA
Entity Type:Individual
Prefix:
First Name:NEASA
Middle Name:
Last Name:MALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NEASA
Other - Middle Name:
Other - Last Name:MALONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPY
Mailing Address - Street 1:2675 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1478
Mailing Address - Country:US
Mailing Address - Phone:704-824-7800
Mailing Address - Fax:704-824-2853
Practice Address - Street 1:332 HIGHWAY 200 NORTH
Practice Address - Street 2:
Practice Address - City:STANFIELD
Practice Address - State:NC
Practice Address - Zip Code:28163-0001
Practice Address - Country:US
Practice Address - Phone:704-824-7800
Practice Address - Fax:704-824-2853
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist