Provider Demographics
NPI:1619115466
Name:CATALONA, MICHAEL C
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:CATALONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-3466
Mailing Address - Country:US
Mailing Address - Phone:563-263-1771
Mailing Address - Fax:
Practice Address - Street 1:1608 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-3466
Practice Address - Country:US
Practice Address - Phone:563-263-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-48171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist