| Brendan Malloy, DC | |
|
2697 Sandy Plains Rd, Marietta, GA 30066-4256 | |
| (770) 971-1355 | |
| (770) 509-8559 |
| Full Name | Brendan Malloy |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 2697 Sandy Plains Rd, Marietta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235431594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIR008742 (Georgia) | Primary |
| Provider Name | Sandy Plains Chiropractic Clinic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1699817767 PECOS PAC ID: 1355507054 Enrollment ID: O20120725000170 |
| Mailing Address | Practice Location Address |
|---|---|
| Brendan Malloy, DC 2697 Sandy Plains Rd, Marietta, GA 30066-4256 Ph: (770) 971-1355 | Brendan Malloy, DC 2697 Sandy Plains Rd, Marietta, GA 30066-4256 Ph: (770) 971-1355 |
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