Provider Demographics
NPI:1407951726
Name:WAHL, MOSES RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:MOSES
Middle Name:RICHARD
Last Name:WAHL
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 1:7360 CREIGHTON PKWY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4513
Mailing Address - Country:US
Mailing Address - Phone:804-559-6818
Mailing Address - Fax:
Practice Address - Street 1:7347 BELL CREEK RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3504
Practice Address - Country:US
Practice Address - Phone:804-559-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor