Individual
ETHAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
991 ROUTE 19 N STE C, WATERFORD, PA 16441-9739
(814) 679-6200
Mailing address
991 ROUTE 19 N STE C, WATERFORD, PA 16441-9739
(814) 679-6200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC011737
PA
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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