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General NPI Number Information
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NPI Number | 1659641264
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Entity Type | Organization
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Legal Business Name | MARY J MOSES DC PA
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 2389 DAVIS BLVD
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City | NAPLES
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State | FL
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Zip | 34104-4200
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Country | US
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Telephone | 239-774-2444
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Fax | 239-774-5470
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Provider Business Mailing Address
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Address Line | 2389 DAVIS BLVD
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City | NAPLES
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State | FL
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Zip | 34104-4200
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Country | US
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Telephone | 239-774-2444
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Fax | 239-774-5470
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Authorized Official
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Title or Position | OWNER
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Name | MARY J MOSES
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Credential | DC PA
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Telephone | 239-774-2444
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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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