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Individual

DR. MARK E O'MALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
78 BEAVER RD, SUITE 2A, WETHERSFIELD, CT 06109-2295
(860) 257-9400
(860) 257-7169
Mailing address
78 BEAVER RD, SUITE 2A, WETHERSFIELD, CT 06109-2295
(860) 257-9400
(860) 257-7169

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CT000731
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050000731CT01
ANTHEM BLUE CROSS
CT
01
2V2010
HEALTHNET
CT
01
4590708
ENVOY/AETNA
CT
01
519710
AETNA
CT
01
682637
CONNECTICARE
CT
Enumeration date
08/31/2006
Last updated
11/18/2010
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