Jonne Allen D Mallari

Individual provider Active NPI Physical Therapist · Tamuning, GU

NPI 1699305656 · NPPES record last updated Jan 17, 2020

Key facts

NPI
1699305656
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT-153 (GU)
Practice address
809 Chalan Pasaheru Unit 2
Tamuning, GU 96913-4132
Phone
(671) 647-5355
Fax
(671) 647-5358
NPI assigned
Jan 17, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-153 GU Yes

Addresses

Primary practice location

809 Chalan Pasaheru Unit 2
Tamuning, GU 96913-4132

Mailing address

PO Box 8838
Tamuning, GU 96931-8838
Phone (671) 647-5355

Other providers in Tamuning, GU

All providers in Tamuning, GU · Physical Therapist in Guam

Sources for this page

Verify at the official NPI Registry.