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Organization

DR MOSES S M SMITH CHIROPRACTIC LLC

Active
Other names
Moe Bodyworks
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOSES SMITH D.C. (CHIROPRACTOR/OWNER)
(612) 824-1829
Entity
Organization

Contact information

Practice address
707 W 34TH ST, MINNEAPOLIS, MN 55408-4138
(612) 824-1829
(612) 823-3808
Mailing address
707 W 34TH ST, MINNEAPOLIS, MN 55408-4138
(612) 824-1829
(612) 823-3808

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4728
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
273P1AC
BLUE CROSS BLUE SHIELD
01
350003454
MEDICARE
05
954603100
MN
01
CC0938A
CHIROCARE LANDMARK
MN
Enumeration date
12/18/2009
Last updated
12/18/2009
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