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General NPI Number Information
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NPI Number | 1578497459
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Entity Type | Individual
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Provider Name | LAUREN MACKENZIE MOORE DC
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Gender | Female
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 2926 SHERWOOD WAY STE 100
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City | SAN ANGELO
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State | TX
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Zip | 76901-3511
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Country | US
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Telephone | 325-208-4842
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Fax |
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Provider Business Mailing Address
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Address Line | 12678 W JENKINS ST
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City | ODESSA
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State | TX
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Zip | 79764-9387
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Country | US
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Telephone | 903-390-0001
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16510
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License Number State | TX
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