Provider Demographics
NPI:1437453313
Name:MOSER, JONATHON PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:PAUL
Last Name:MOSER
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 1:411 MAIN ST
Mailing Address - Street 2:P.O. BOX C
Mailing Address - City:MC GREGOR
Mailing Address - State:IA
Mailing Address - Zip Code:52157-8767
Mailing Address - Country:US
Mailing Address - Phone:563-880-3358
Mailing Address - Fax:
Practice Address - Street 1:333 MAIN ST
Practice Address - Street 2:P.O. BOX C
Practice Address - City:MC GREGOR
Practice Address - State:IA
Practice Address - Zip Code:52157-8778
Practice Address - Country:US
Practice Address - Phone:563-873-3404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor