Provider Demographics
NPI:1568696359
Name:MAOLA, CHAD J (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:J
Last Name:MAOLA
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 1:7200 66TH ST. N.
Mailing Address - Street 2:CARUTH HEALTH EDUCATION CENTER
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7200 66TH ST. N.
Practice Address - Street 2:CARUTH HEALTH EDUCATION CENTER
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781
Practice Address - Country:US
Practice Address - Phone:727-394-6217
Practice Address - Fax:727-394-6015
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCFC 3111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor