Provider Demographics
NPI:1609125053
Name:MALONEY CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:MALONEY CHIROPRACTIC, INC
Other - Org Name:MALONEY CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-955-2858
Mailing Address - Street 1:2525 E THOMAS RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7935
Mailing Address - Country:US
Mailing Address - Phone:602-955-2858
Mailing Address - Fax:602-955-5522
Practice Address - Street 1:2525 E THOMAS RD
Practice Address - Street 2:SUITE #1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7935
Practice Address - Country:US
Practice Address - Phone:602-955-2858
Practice Address - Fax:602-955-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ5053111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ24535Medicare UPIN