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Individual

MARTIN R MOFFETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
607 W OAK ST, WEST FRANKFORT, IL 62896-2537
(618) 937-3509
(618) 937-3500
Mailing address
607 W OAK ST, WEST FRANKFORT, IL 62896-2537
(618) 937-3509
(618) 937-3500

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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