Individual
DR. JEDEDIAH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
19332 HIGHWAY 169, ELK RIVER, MN 55330-4645
(763) 441-7788
Mailing address
19332 HIGHWAY 169, ELK RIVER, MN 55330-4645
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5700
MN
Other
Enumeration date
09/02/2012
Last updated
09/02/2012
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