Provider Demographics
NPI:1497467559
Name:MALONE, AIMEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:MALONE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 ENDVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BELDEN
Mailing Address - State:MS
Mailing Address - Zip Code:38826-8882
Mailing Address - Country:US
Mailing Address - Phone:662-509-2480
Mailing Address - Fax:
Practice Address - Street 1:2927 ENDVILLE RD
Practice Address - Street 2:
Practice Address - City:BELDEN
Practice Address - State:MS
Practice Address - Zip Code:38826-8882
Practice Address - Country:US
Practice Address - Phone:662-509-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT7265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist