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General NPI Number Information
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NPI Number | 1205961463
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Entity Type | Organization
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Legal Business Name | MOORE CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 707 SUNSET ST
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City | DENTON
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State | TX
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Zip | 76201-2668
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Country | US
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Telephone | 940-383-9399
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Fax | 940-566-8630
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Provider Business Mailing Address
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Address Line | 707 SUNSET ST
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City | DENTON
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State | TX
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Zip | 76201-2668
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Country | US
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Telephone | 940-383-9399
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Fax | 940-566-8630
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Authorized Official
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Title or Position | OWNER
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Name | DR. J KENNETH MOORE
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Credential | D.C.
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Telephone | 940-383-9399
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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 | DC5766
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License Number State | TX
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