Provider Demographics
NPI:1477698934
Name:MALLOY, JANICE E (CMT)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:E
Last Name:MALLOY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 STREET RD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020
Mailing Address - Country:US
Mailing Address - Phone:215-244-1999
Mailing Address - Fax:215-245-0987
Practice Address - Street 1:1950 STREET RD
Practice Address - Street 2:SUITE 318 BENSALEM MUSCLE THERAPY
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-244-1999
Practice Address - Fax:215-245-0987
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
05486900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist