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NPI Code Detail

MEDICARE: BRENDAN MALLOY D.C.

MEDICARE: BRENDAN MALLOY D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHIR008742GA

General Provider Information

NPI Number : 1235431594
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDAN MALLOY D.C.
Provider Business Mailing Address
First Line : 2697 SANDY PLAINS RD
Second Line :
City : MARIETTA
State : GA
Zip : 30066-4256
Country : US
Telephone Number : 770-971-1355
Fax Number : 770-509-8559
Provider Business Practice Location Address
First Line : 2697 SANDY PLAINS RD
Second Line :
City : MARIETTA
State : GA
Zip : 30066-4256
Country : US
Telephone Number : 770-971-1355
Fax Number : 770-509-8559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2010
Last Update Date : 11/18/2010

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Directions to “ BRENDAN MALLOY D.C.” Practice Location

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