Individual
DR. FAXON D MOULDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
66 E STATE RD, PLEASANT GROVE, UT 84062-2637
(801) 796-7961
(801) 796-1104
Mailing address
66 E STATE RD, PLEASANT GROVE, UT 84062-2637
(801) 796-7961
(801) 796-1104
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2774319-41202
UT
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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