Organization
LAKELAND CHIROPRACTIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY M. MALONEY D.C. (PRESIDENT)
(770) 781-9050
Entity
Organization
Contact information
Practice address
563 LAKELAND PLZ, CUMMING, GA 30040-2784
(770) 781-9050
(770) 781-5801
Mailing address
563 LAKELAND PLZ, CUMMING, GA 30040-2784
(770) 781-9050
(770) 781-5801
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006869
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52223231-001
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/30/2007
Last updated
07/30/2007
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