Provider Demographics
NPI:1992945588
Name:MALINE FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:MALINE FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MALINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-341-6601
Mailing Address - Street 1:127 ARBUTUS AVE
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854-1453
Mailing Address - Country:US
Mailing Address - Phone:906-341-6601
Mailing Address - Fax:906-341-5134
Practice Address - Street 1:127 ARBUTUS AVE
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-1453
Practice Address - Country:US
Practice Address - Phone:906-341-6601
Practice Address - Fax:906-341-5134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010177261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center