Individual
MISS JAMES CLARENCE MOOTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D,C,
Contact information
Practice address
1427 1ST ST S, WILLMAR, MN 56201-4221
(320) 235-7506
(320) 235-7506
Mailing address
1427 1ST ST S, WILLMAR, MN 56201-4221
(320) 235-7506
(320) 235-7506
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1362
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4D032M0
BLUECROSS BLUESHIELD INS
MN
Enumeration date
12/11/2006
Last updated
07/08/2007
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