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NPI Code Detail

MEDICARE: DR. RACHEL AILI MOORE D.C.

MEDICARE: DR. RACHEL AILI MOORE D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor5260MN

General Provider Information

NPI Number : 1619108917
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL AILI MOORE D.C.
Provider Business Mailing Address
First Line : 2125 E HENNEPIN AVE STE 300
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1763
Country : US
Telephone Number : 612-750-7168
Fax Number : 612-564-7373
Provider Business Practice Location Address
First Line : 2125 E HENNEPIN AVE STE 300
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1763
Country : US
Telephone Number : 612-750-7168
Fax Number : 612-564-7373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2009
Last Update Date : 08/09/2019

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