Provider Demographics
NPI:1346369964
Name:MALUCCI, JEFFREY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:MALUCCI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5505 BELLS FERRY ROAD
Mailing Address - Street 2:BUILDING 300 SUITE 240
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30189
Mailing Address - Country:US
Mailing Address - Phone:678-445-1400
Mailing Address - Fax:678-445-4585
Practice Address - Street 1:5505 BELLS FERRY RD
Practice Address - Street 2:BUILDING 300 SUITE 240
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-7527
Practice Address - Country:US
Practice Address - Phone:678-445-1400
Practice Address - Fax:678-445-4585
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor