Provider Demographics
NPI:1508111683
Name:MALONE, MATTHEW WILLIAM (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WILLIAM
Last Name:MALONE
Suffix:
Gender:M
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 1:1312 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-5355
Mailing Address - Country:US
Mailing Address - Phone:903-572-6100
Mailing Address - Fax:903-572-6127
Practice Address - Street 1:1406 SHADYWOOD LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-5337
Practice Address - Country:US
Practice Address - Phone:903-572-6100
Practice Address - Fax:903-572-6127
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1219669174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist