Provider Demographics
NPI:1154078194
Name:MOVING BODY CHIROPRACTIC
Entity Type:Organization
Organization Name:MOVING BODY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-239-2702
Mailing Address - Street 1:2536 YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2763
Mailing Address - Country:US
Mailing Address - Phone:203-536-8417
Mailing Address - Fax:
Practice Address - Street 1:1532 N EMERSON ST UNIT 103-104
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1450
Practice Address - Country:US
Practice Address - Phone:720-239-2702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty