MEDICARE: DR. SANDRA J 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	2301009090	MI

General Provider Information

NPI Number	:	1285725523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA J MOORE D.C.

Provider Business Mailing Address
First Line	:	1877 N GETTY ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-8563
Country	:	US
Telephone Number	:	231-744-5200
Fax Number	:	231-744-9484

Provider Business Practice Location Address
First Line	:	1877 N GETTY ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-8563
Country	:	US
Telephone Number	:	231-744-5200
Fax Number	:	231-744-9484

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	04/23/2024

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Directions to “ DR. SANDRA J MOORE D.C.” Practice Location

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