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Individual

DR. RICHARD LEE MOXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC CCEP

Contact information

Practice address
93 S PIONEER RD STE 200, FOND DU LAC, WI 54936-1776
(920) 907-1283
(920) 907-1285
Mailing address
N6463 S PIONEER RD, FOND DU LAC, WI 54935-3853
(920) 907-1283
(920) 907-1285

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3019
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38880600
WI
Enumeration date
03/06/2007
Last updated
06/14/2018
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