Provider Demographics
NPI:1851589436
Name:MALANOSKY, PEGGY ANN (LMT)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:ANN
Last Name:MALANOSKY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1489 LOCUST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1337
Mailing Address - Country:US
Mailing Address - Phone:304-367-9355
Mailing Address - Fax:304-367-9366
Practice Address - Street 1:1489 LOCUST AVE
Practice Address - Street 2:STE B
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-1337
Practice Address - Country:US
Practice Address - Phone:304-367-9355
Practice Address - Fax:304-367-9366
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist