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General NPI Number Information
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NPI Number | 1518644277
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Entity Type | Organization
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Legal Business Name | MOSS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 2201 N 30TH ST STE C
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City | TACOMA
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State | WA
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Zip | 98403-3361
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Country | US
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Telephone | 253-254-5737
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 N 30TH ST STE C
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City | TACOMA
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State | WA
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Zip | 98403-3361
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Country | US
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Telephone | 971-284-2863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CODY MOSS
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Credential | D.C.
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Telephone | 971-284-2863
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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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