Provider Demographics
NPI:1326119413
Name:MOLDA, CHRISTOPHER JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:MOLDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 US ROUTE 1
Mailing Address - Street 2:SUITE 4
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1653
Mailing Address - Country:US
Mailing Address - Phone:207-363-5656
Mailing Address - Fax:
Practice Address - Street 1:529 US ROUTE 1
Practice Address - Street 2:SUITE 4
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1653
Practice Address - Country:US
Practice Address - Phone:207-363-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME0969Medicare ID - Type Unspecified