Provider Demographics
NPI:1063294031
Name:MALOOF, KATHRYN LUCILLE (DC)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LUCILLE
Last Name:MALOOF
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 1:1235 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-3003
Mailing Address - Country:US
Mailing Address - Phone:770-923-1111
Mailing Address - Fax:
Practice Address - Street 1:1235 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-3003
Practice Address - Country:US
Practice Address - Phone:770-923-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO011040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor