Provider Demographics
NPI:1588964209
Name:MALINOWSKI, JOHN L (ATC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:L
Last Name:MALINOWSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:293 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2423
Mailing Address - Country:US
Mailing Address - Phone:805-748-3322
Mailing Address - Fax:
Practice Address - Street 1:2530 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1602
Practice Address - Country:US
Practice Address - Phone:805-928-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer