Organization
MOORE-FULCHER LLC
Active
Other names
PRIME LIFE CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI KOREEN MOORE (MANAGER)
(972) 424-2225
Entity
Organization
Contact information
Practice address
2504 AVENUE K, STE 500, PLANO, TX 75074-5340
(972) 424-2225
(972) 424-7709
Mailing address
2504 AVENUE K, STE 500, PLANO, TX 75074-5340
(972) 424-2225
(972) 424-7709
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC9953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0084QG
BLUE CROSS
TX
01
—
8R9800
BLUE CROSS
—
Enumeration date
09/25/2007
Last updated
01/16/2013
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