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General NPI Number Information
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NPI Number | 1508878463
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Entity Type | Individual
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Provider Name | STEVEN ROGER MOORING D.C., N.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 2505 KACHINA DR.
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City | PUEBLO
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State | CO
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Zip | 81008-1672
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Country | US
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Telephone | 719-544-2009
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Fax | 719-253-7734
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Provider Business Mailing Address
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Address Line | 2505 KACHINA DR.
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City | PUEBLO
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State | CO
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Zip | 81008-1672
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Country | US
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Telephone | 719-544-2009
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Fax | 719-253-7734
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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 | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 2788
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 2788
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License Number State | CO
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