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General NPI Number Information
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NPI Number | 1710126842
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Entity Type | Organization
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Legal Business Name | MOSENG HEALTH CARE INC.
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 117 ROUTE 66 STE. 190
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City | WILLIAMS
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State | AZ
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Zip | 86046
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Country | US
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Telephone | 928-300-9904
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Fax |
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Provider Business Mailing Address
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Address Line | 240 JENNIFER DR STE. 103
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4199
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Country | US
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Telephone | 928-634-0733
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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. BRUCE ALAN MOSENG
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Credential |
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Telephone | 928-634-0733
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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 | 7085
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License Number State | AZ
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