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NPI Code Detail

MEDICARE: JASON DAVID MOORE LAC

MEDICARE: JASON DAVID MOORE LAC
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
1171100000XAcupuncturist65.000438OH

General Provider Information

NPI Number : 1982917571
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON DAVID MOORE LAC
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-9777
Fax Number : 614-293-9677
Provider Business Practice Location Address
First Line : 3200 TREMONT RD
Second Line :
City : UPPER ARLINGTON
State : OH
Zip : 43221-2040
Country : US
Telephone Number : 614-293-9777
Fax Number : 614-293-9677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2010
Last Update Date : 02/10/2025

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Directions to “ JASON DAVID MOORE LAC” Practice Location

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