Provider Demographics
NPI:1225510035
Name:MOREAUXLLC
Entity Type:Organization
Organization Name:MOREAUXLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-205-8179
Mailing Address - Street 1:850 SISKIYOU BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2125
Mailing Address - Country:US
Mailing Address - Phone:541-482-0342
Mailing Address - Fax:
Practice Address - Street 1:850 SISKIYOU BLVD STE 7
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2125
Practice Address - Country:US
Practice Address - Phone:541-482-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty