Healthcare Provider Details

I. General information

NPI: 1285969204
Provider Name (Legal Business Name): MELISSA LYNNE MOYER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 W HIGH ST
BELLEFONTE PA
16823-1302
US

IV. Provider business mailing address

218 W HIGH ST
BELLEFONTE PA
16823-1302
US

V. Phone/Fax

Practice location:
  • Phone: 814-954-0280
  • Fax:
Mailing address:
  • Phone: 814-954-0280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010327
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: