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General NPI Number Information
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NPI Number | 1689927204
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Entity Type | Organization
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Legal Business Name | DEVIN MOORE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 2925 W WALNUT ST
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City | ROGERS
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State | AR
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Zip | 72756-0338
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Country | US
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Telephone | 479-636-6609
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 W WALNUT
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City | ROGERS
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State | AR
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Zip | 72756
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Country | US
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Telephone | 479-636-6609
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Fax | 479-636-7725
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEVIN MOORE
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Credential | D.C.
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Telephone | 479-636-6609
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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 | 15987
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License Number State | AR
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