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General NPI Number Information
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NPI Number | 1073958815
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Entity Type | Individual
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Provider Name | JABAN M MOORE D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 420 ARMOUR RD
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3512
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Country | US
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Telephone | 816-889-9801
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Fax | 816-889-9802
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Provider Business Mailing Address
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Address Line | 925 CHARLOTTE ST
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City | KANSAS CITY
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State | MO
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Zip | 64106-3034
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Country | US
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Telephone | 816-889-9801
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Fax | 816-889-9802
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2013013283
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License Number State | MO
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