Provider Demographics
NPI:1780885061
Name:VALLONE, MARY CHRISTINE (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CHRISTINE
Last Name:VALLONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3027
Mailing Address - Country:US
Mailing Address - Phone:856-858-8904
Mailing Address - Fax:
Practice Address - Street 1:425 KINGS HWY E
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1206
Practice Address - Country:US
Practice Address - Phone:856-429-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00274800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist