Malmquist, Kelly J

Malmquist, Kelly J is an individual health care provider with primary practice located at 1040 Pilgrim Way , Green Bay WI 54304-5028. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Malmquist, Kelly J can be contacted via phone (920) 405-3522.

Contact Information

Primary practice address
1040 Pilgrim Way Green Bay WI 54304-5028
Phone: (920) 405-3522
Fax: (920) 405-3523
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 1321019 Wisconsin

Profile Details

NPI number 1609922665
LBN Legal business name Malmquist, Kelly J
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Apr 23rd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609922665 NPPES
Wisconsin MEDICAID 36120300

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