Provider Demographics
NPI:1386953008
Name:MAHONEY, LIAM (PT)
Entity type:Individual
Prefix:MR
First Name:LIAM
Middle Name:
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:600 OAKMONT LN
Mailing Address - Street 2:STE 600C
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:4004 PEACH CT
Practice Address - Street 2:SUITE H
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3800
Practice Address - Country:US
Practice Address - Phone:573-256-8100
Practice Address - Fax:573-256-8104
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2020-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO1176962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic