MEDICARE: MOSHER CHIROPRACTIC PA

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
1	111NN1001X	Nutrition Chiropractor	CH0007079	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902024557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSHER CHIROPRACTIC PA

Provider Business Mailing Address
First Line	:	6205 DR MLK JR ST SOUTH
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705
Country	:	US
Telephone Number	:	727-864-1701
Fax Number	:	727-866-6178

Provider Business Practice Location Address
First Line	:	6205 DR MLK JR ST SOUTH
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705
Country	:	US
Telephone Number	:	727-864-1701
Fax Number	:	727-866-6178

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. DAVID PETER MOSHER
Credential	:	D.C.
Telephone Number	:	727-864-1701

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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Directions to “MOSHER CHIROPRACTIC PA ” Practice Location

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