Provider Demographics
NPI:1356413389
Name:MALONE, PHYLLIS HUBER (PT)
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:HUBER
Last Name:MALONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:PHYLLIS
Other - Middle Name:EILEEN
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:2760 ELBA LANE
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2608
Mailing Address - Country:US
Mailing Address - Phone:412-492-1146
Mailing Address - Fax:412-492-1146
Practice Address - Street 1:2760 ELBA LANE
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2608
Practice Address - Country:US
Practice Address - Phone:412-492-1146
Practice Address - Fax:412-492-1146
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004099L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist