MEDICARE: DR. ADAM T MOLDEN 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
1	111N00000X	Chiropractor	11419	TX
2	111N00000X	Chiropractor	8232	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1992020630	OTHER	TX	NPI

General Provider Information

NPI Number	:	1992020630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM T MOLDEN D.C.

Provider Business Mailing Address
First Line	:	2292 W MAGEE RD
Second Line	:	SUITE 170
City	:	TUCSON
State	:	AZ
Zip	:	85742-4301
Country	:	US
Telephone Number	:	520-797-2922
Fax Number	:	520-742-0732

Provider Business Practice Location Address
First Line	:	2292 W MAGEE RD
Second Line	:	SUITE 170
City	:	TUCSON
State	:	AZ
Zip	:	85742-4301
Country	:	US
Telephone Number	:	520-797-2922
Fax Number	:	520-742-0732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	03/21/2012

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Directions to “ DR. ADAM T MOLDEN D.C.” Practice Location

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