Provider Demographics
NPI:1093949596
Name:MORETTI, MOSES (DC)
Entity Type:Individual
Prefix:DR
First Name:MOSES
Middle Name:
Last Name:MORETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 ROANOKE RD
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3202
Mailing Address - Country:US
Mailing Address - Phone:540-992-3354
Mailing Address - Fax:540-992-5067
Practice Address - Street 1:1298 ROANOKE RD
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3202
Practice Address - Country:US
Practice Address - Phone:540-992-3354
Practice Address - Fax:540-992-5067
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3467111N00000X
VA0104556790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor