| NPI | 1467066563 | 
|---|---|
| Former Name | CAROLINE AMANDA MALONE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014934) | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT014934) | 
| Enumeration Date | 2020-09-04 | 
| Last Update Date | 2023-02-06 |