Individual
DR. JASON DEWITT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2204 2ND AVE W STE 102, WILLISTON, ND 58801-3485
(701) 577-7771
Mailing address
2204 2ND AVE W STE 102, WILLISTON, ND 58801-3485
(701) 577-7771
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1087
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1087
CHIROPRACTIC STATE BOARD
ND
Enumeration date
01/23/2019
Last updated
03/16/2020
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