Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 000118 | MS |
N | 111N00000X | Chiropractor | 1437 | LA |
N | 111NR0400X | Rehabilitation Chiropractor | 000118 | MS |
N | 111NR0400X | Rehabilitation Chiropractor | 1437 | LA |
NPI | 1386701944 |
---|---|
Provider Name | Dr. Debbie L Moore |
First Address | Picayune, MS 39466-0326 |
Second Address | Carriere, MS 39426-7554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 27/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09088559 | (05) | MS |