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General NPI Number Information
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NPI Number | 1679646483
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Entity Type | Organization
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Legal Business Name | FOOTHILL CHIROPRACTIC CORP
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 13955 MONO WAY SUITE A
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City | SONORA
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State | CA
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Zip | 95370-2832
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Country | US
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Telephone | 209-532-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 13955 MONO WAY SUITE A
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City | SONORA
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State | CA
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Zip | 95370-2832
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Country | US
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Telephone | 209-532-3700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL R MOFFAT
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Credential | D.C.
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Telephone | 209-532-3700
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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 | CA
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