Individual
DR. CHANTEL L MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
7211 EAST GENESEE STREET, FAYETTEVILLE, NY 13066
(315) 637-0706
(315) 637-0708
Mailing address
7211 EAST GENESEE STREET, FAYETTEVILLE, NY 13066
(315) 637-0706
(315) 637-0708
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X010670
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C106700W
WORKERS COMP
NY
Enumeration date
10/14/2006
Last updated
07/08/2007
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