Organization
CROW WING CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEDEDIAH MOORE D.C. (CHIROPRACTOR)
(218) 205-1908
Entity
Organization
Contact information
Practice address
15229 EDGEWOOD DR STE 125, BAXTER, MN 56401-6920
(218) 205-1908
Mailing address
15229 EDGEWOOD DR STE 125, BAXTER, MN 56425
(218) 454-2840
(218) 454-2841
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5700
MN
Other
Enumeration date
04/16/2014
Last updated
06/04/2014
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