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General NPI Number Information
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NPI Number | 1386283182
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Entity Type | Organization
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Legal Business Name | JENSEN MOORE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 12/27/2019
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 6033 W BELL RD STE H
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City | GLENDALE
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State | AZ
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Zip | 85308-3764
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Country | US
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Telephone | 602-978-3321
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Fax | 602-978-5701
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Provider Business Mailing Address
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Address Line | 6033 W BELL RD STE H
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City | GLENDALE
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State | AZ
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Zip | 85308-3764
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Country | US
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Telephone | 602-978-3321
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Fax | 602-978-5701
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Authorized Official
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Title or Position | CEO
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Name | JENSEN M MOORE
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Credential | DC
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Telephone | 602-978-3321
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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 |
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License Number State |
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