Provider Demographics
NPI:1154715399
Name:MOYER, MICHAEL ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:MOYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 N BLUFF ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4543
Mailing Address - Country:US
Mailing Address - Phone:435-628-2155
Mailing Address - Fax:435-628-5999
Practice Address - Street 1:237 N BLUFF ST
Practice Address - Street 2:SUITE A
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4543
Practice Address - Country:US
Practice Address - Phone:435-628-2155
Practice Address - Fax:435-628-5999
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32205111N00000X
UT9585273-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor