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General NPI Number Information
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NPI Number | 1760668479
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Entity Type | Organization
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Legal Business Name | HENRY J MALEC DCPC
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 247 N MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-1238
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Country | US
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Telephone | 734-451-1202
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 DEWEY ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-2001
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Country | US
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Telephone | 313-715-3995
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HENRY JOSEPH MALEC
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Credential | D.C.P.C.
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Telephone | 313-715-3995
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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 | 2301001777
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License Number State | MI
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