Provider Demographics
NPI:1104836691
Name:MOSEY CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:MOSEY CHIROPRACTIC LTD
Other - Org Name:LIFE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MOSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-233-3600
Mailing Address - Street 1:2800 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6030
Mailing Address - Country:US
Mailing Address - Phone:701-237-0614
Mailing Address - Fax:701-237-0615
Practice Address - Street 1:2800 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6030
Practice Address - Country:US
Practice Address - Phone:701-237-0614
Practice Address - Fax:701-237-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty