Provider Demographics
NPI:1316076342
Name:MULAK CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:MULAK CHIROPRACTIC CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MULAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-272-5710
Mailing Address - Street 1:411 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909
Mailing Address - Country:US
Mailing Address - Phone:401-272-5710
Mailing Address - Fax:401-272-5711
Practice Address - Street 1:411 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909
Practice Address - Country:US
Practice Address - Phone:401-272-5710
Practice Address - Fax:401-272-5711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI648874OtherUNITED HEALTH
RI214665OtherBCBS
RI410060OtherBLUE CHIP
U95068Medicare UPIN