Provider Demographics
NPI:1033416326
Name:MALDEN CHIROPRACTIC L.L.C.
Entity Type:Organization
Organization Name:MALDEN CHIROPRACTIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASSANDRA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-778-6915
Mailing Address - Street 1:123 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MO
Mailing Address - Zip Code:63863-2162
Mailing Address - Country:US
Mailing Address - Phone:573-276-3892
Mailing Address - Fax:573-276-3893
Practice Address - Street 1:123 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-2162
Practice Address - Country:US
Practice Address - Phone:573-276-3892
Practice Address - Fax:573-276-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014270111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty