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Organization
MOORE ABUNDANT LIFE CHIROPRACTIC LLC
Active
Organization
MOORE ABUNDANT LIFE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON NICHOLAS MOORE D.C. (OWNER)
(817) 358-0209
Entity
Organization
Contact information
Practice address
4008 GATEWAY DR, SUITE 180, COLLEYVILLE, TX 76034-7914
(817) 571-9700
(817) 358-0219
Mailing address
4008 GATEWAY DR, SUITE 180, COLLEYVILLE, TX 76034-7914
(817) 571-9700
(817) 358-0219
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10451
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067QG
BCBS GROUP #
TX
01
—
613000
MEDICARE
TX
Enumeration date
10/24/2007
Last updated
05/13/2014
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