Provider Demographics
NPI:1023218849
Name:MALONE FAMILY CHIROPRACTIC CLINIC P.C.
Entity type:Organization
Organization Name:MALONE FAMILY CHIROPRACTIC CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-585-0139
Mailing Address - Street 1:950 CEDAR CROSS RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7743
Mailing Address - Country:US
Mailing Address - Phone:563-585-0139
Mailing Address - Fax:563-585-0140
Practice Address - Street 1:950 CEDAR CROSS RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-7743
Practice Address - Country:US
Practice Address - Phone:563-585-0139
Practice Address - Fax:563-585-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06173111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0181537Medicaid
IA0181537Medicaid
IAI4640Medicare PIN