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General NPI Number Information
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NPI Number | 1063570661
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Entity Type | Organization
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Legal Business Name | MALTER CHIROPRACTIC CENTER, P.C.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 45280 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5600
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Country | US
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Telephone | 586-254-3303
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Fax | 586-254-1121
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Provider Business Mailing Address
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Address Line | 45280 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5600
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Country | US
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Telephone | 586-254-3303
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Fax | 586-254-1121
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY M MALTER
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Credential | D.C.
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Telephone | 586-254-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301005931
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License Number State | MI
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