Healthcare Provider Details

I. General information

NPI: 1083318315
Provider Name (Legal Business Name): ALEX ELIZABETH MOORE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 W POINSETT ST STE D
GREER SC
29650-1251
US

IV. Provider business mailing address

1317 W POINSETT ST STE D
GREER SC
29650-1251
US

V. Phone/Fax

Practice location:
  • Phone: 864-590-0034
  • Fax:
Mailing address:
  • Phone: 864-590-0034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4911
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: