Provider Demographics
NPI:1992020630
Name:MOLDEN, ADAM T (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:T
Last Name:MOLDEN
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 1:2292 W MAGEE RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-4301
Mailing Address - Country:US
Mailing Address - Phone:520-797-2922
Mailing Address - Fax:520-742-0732
Practice Address - Street 1:2292 W MAGEE RD
Practice Address - Street 2:SUITE 170
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-4301
Practice Address - Country:US
Practice Address - Phone:520-797-2922
Practice Address - Fax:520-742-0732
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11419111N00000X
AZ8232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992020630OtherNPI
TX1992020630OtherNPI
TXTXB117867Medicare PIN