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Individual

JOHN RICHARD MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
809 WHEELER ST STE 2, AMES, IA 50010-4367
(515) 233-1709
(515) 232-1917
Mailing address
809 WHEELER ST STE 2, AMES, IA 50010-4367
(515) 233-1709
(515) 232-1917

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5288
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0087973
IA
01
1144210212
INDIVIDUAL NPI
IA
01
1346383619
GROUP NPI
IA
01
42678
BCBS
IA
05
IA 17029
IA
Enumeration date
10/28/2005
Last updated
04/06/2010
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