Individual
DR. MATHEW DAVID MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
500 E FLORIDA ST, HOLBROOK, AZ 86025-2724
(928) 524-1900
Mailing address
500 E FLORIDA ST, HOLBROOK, AZ 86025-2724
(928) 524-1900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5746AZ
AZ
111N00000X
Chiropractor
CHR4245
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
963414
—
AZ
01
—
AZ0944980
BLUE CROSS BLUE SHIELD
AZ
01
—
P00244481
RAILROAD MEDICARE
AZ
Enumeration date
08/03/2006
Last updated
05/02/2012
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