Provider Demographics
NPI:1275667826
Name:MOORE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:MOORE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-826-5555
Mailing Address - Street 1:90 ROCKLAND ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2235
Mailing Address - Country:US
Mailing Address - Phone:781-826-5555
Mailing Address - Fax:
Practice Address - Street 1:90 ROCKLAND ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2235
Practice Address - Country:US
Practice Address - Phone:781-826-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty