Provider Demographics
NPI:1801182993
Name:MAHONEY, COLLEEN CATHERINE (DC)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:CATHERINE
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4354
Mailing Address - Country:US
Mailing Address - Phone:480-726-2614
Mailing Address - Fax:480-726-6798
Practice Address - Street 1:312 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE 19
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4354
Practice Address - Country:US
Practice Address - Phone:480-726-2614
Practice Address - Fax:480-726-6798
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor