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Individual
MARTIN R MOFFETT
Active
Individual
MARTIN R MOFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2832034
BLUE CROSS BLUE SHIELD OF ILLINOIS PIN
—
01
—
929137
HEALTHLINK PIN
—
Enumeration date
01/22/2007
Last updated
08/23/2013
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