Provider Demographics
NPI:1194804484
Name:MORAN, GEORGE FRANCIS (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:FRANCIS
Last Name:MORAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:FRANCIS
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3665 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-6865
Mailing Address - Country:US
Mailing Address - Phone:904-396-4985
Mailing Address - Fax:904-396-4985
Practice Address - Street 1:3665 MIMOSA DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-6865
Practice Address - Country:US
Practice Address - Phone:904-396-4985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor