Provider Demographics
NPI:1942424833
Name:MALONE, ERIN SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:SEAN
Last Name:MALONE
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 1:202 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2914
Mailing Address - Country:US
Mailing Address - Phone:989-725-2255
Mailing Address - Fax:989-725-2258
Practice Address - Street 1:202 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2914
Practice Address - Country:US
Practice Address - Phone:989-725-2255
Practice Address - Fax:989-725-2258
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIEM008318111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU83405Medicare UPIN
MION32300Medicare ID - Type Unspecified