Organization
MOON CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRYL MOON DC (CHIROPRACTOR)
(701) 474-5948
Entity
Organization
Contact information
Practice address
110 MAIN AVE., FAIRMOUNT, ND 58030
(701) 474-5948
Mailing address
PO BOX 291, FAIRMOUNT, ND 58030-0291
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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