Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MALLORY FAHNESTOCK, DPT
ActivePhysical Medicine & Rehabilitation · PERRYVILLE, MO
Registration Details
- NPI Number
- 1265856173
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 12, 2014 (12.229326299279 yrs)
- Last Updated
- Feb 12, 2014
- License
-
2014004288 (MO)
Practice Information
- Address
-
1506 W SAINT JOSEPH STPERRYVILLE, MO, 637751504Browse MO providers · Browse ZIP 63775
- Phone
- 5735177900
- Primary Specialty
-
Physical Medicine & Rehabilitation
208100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.