Provider Demographics
NPI:1437507852
Name:MALTON VENTURES, LLC
Entity Type:Organization
Organization Name:MALTON VENTURES, LLC
Other - Org Name:CAPITAL CHIROPRACTIC CENTER OF GUILFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-533-4316
Mailing Address - Street 1:705 BOSTON POST RD STE C8
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2732
Mailing Address - Country:US
Mailing Address - Phone:203-533-4316
Mailing Address - Fax:
Practice Address - Street 1:705 BOSTON POST RD STE C8
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2732
Practice Address - Country:US
Practice Address - Phone:203-533-4316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty