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Individual

DR. JACK ALONZO MOSES JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
51210 ROMEO PLANK RD, MACOMB, MI 48042-4129
(586) 323-5060
(586) 323-5062
Mailing address
PO BOX 183051, SHELBY TOWNSHIP, MI 48318-3051
(586) 323-5060
(586) 323-5062

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008704
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E01692
BLUECROSS
MI
Enumeration date
09/14/2005
Last updated
09/09/2011
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