Provider Demographics
NPI:1568630283
Name:MOORE, KORY LANE (DC)
Entity Type:Individual
Prefix:DR
First Name:KORY
Middle Name:LANE
Last Name:MOORE
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 1:321 W EXCHANGE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1708
Mailing Address - Country:US
Mailing Address - Phone:330-252-9969
Mailing Address - Fax:330-252-9976
Practice Address - Street 1:321 W EXCHANGE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1708
Practice Address - Country:US
Practice Address - Phone:330-252-9969
Practice Address - Fax:330-252-9976
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor