Provider Demographics
NPI:1154633782
Name:SELIGA MOORE, PATRICIA (DC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SELIGA MOORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WILLARD ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1200
Mailing Address - Country:US
Mailing Address - Phone:617-471-4491
Mailing Address - Fax:617-984-0636
Practice Address - Street 1:1095 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-7944
Practice Address - Country:US
Practice Address - Phone:508-761-9000
Practice Address - Fax:508-761-9111
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor