Provider Demographics
NPI:1609266691
Name:GABRIEL, MALONIE (LMT)
Entity Type:Individual
Prefix:
First Name:MALONIE
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MARGIT
Other - Middle Name:
Other - Last Name:ZAVODSZKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:733 E 6TH PL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-6303
Mailing Address - Country:US
Mailing Address - Phone:480-668-1448
Mailing Address - Fax:480-272-7608
Practice Address - Street 1:733 E 6TH PL
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-6303
Practice Address - Country:US
Practice Address - Phone:480-668-1448
Practice Address - Fax:480-272-7608
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#MT-05865172M00000X
NM6436172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist