MEDICARE: DR. JOHN W. MOORE 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	08001075	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093835126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN W. MOORE D.C.

Provider Business Mailing Address
First Line	:	822 W WHITE RIVER BLVD
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47303-3868
Country	:	US
Telephone Number	:	765-288-4769
Fax Number	:	765-284-8595

Provider Business Practice Location Address
First Line	:	822 W WHITE RIVER BLVD
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47303-3868
Country	:	US
Telephone Number	:	765-288-4769
Fax Number	:	765-284-8595

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	08/01/2022

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Directions to “ DR. JOHN W. MOORE D.C.” Practice Location

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