Healthcare Provider Details

I. General information

NPI: 1528828340
Provider Name (Legal Business Name): MOSES CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW STE 207
WASHINGTON DC
20011-1137
US

IV. Provider business mailing address

6323 GEORGIA AVE NW STE 207
WASHINGTON DC
20011-1137
US

V. Phone/Fax

Practice location:
  • Phone: 202-546-2000
  • Fax: 202-546-2001
Mailing address:
  • Phone: 202-546-2000
  • Fax: 202-546-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MOSES OSAZUWA OGBEMUDIA
Title or Position: CHIROPRACTOR CEO
Credential: DC
Phone: 202-546-2000