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General NPI Number Information
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NPI Number | 1285064337
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Entity Type | Organization
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Legal Business Name | JILL MOORE LLC
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 1229 HICKORY BROOK CT
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City | BEL AIR
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State | MD
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Zip | 21014-1865
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Country | US
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Telephone | 410-638-8006
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Fax | 410-638-8711
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Provider Business Mailing Address
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Address Line | 1229 HICKORY BROOK CT
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City | BEL AIR
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State | MD
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Zip | 21014-1865
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Country | US
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Telephone | 410-638-8006
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Fax | 410-638-8711
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Authorized Official
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Title or Position | PRESIDENT
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Name | JILL MOORE
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Credential | DC
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Telephone | 410-790-8524
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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 | S03572
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License Number State | MD
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