Provider Demographics
NPI:1215979356
Name:MULLANEY, MICHAEL JOSEPH III (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:MULLANEY
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 BRUSH CREEK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-2085
Mailing Address - Country:US
Mailing Address - Phone:707-538-3000
Mailing Address - Fax:707-303-7199
Practice Address - Street 1:100 BRUSH CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-2085
Practice Address - Country:US
Practice Address - Phone:707-538-3000
Practice Address - Fax:707-303-7199
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor