Provider Demographics
NPI:1639580491
Name:MOCEUS, JOSEPH (LAC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MOCEUS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 WILLOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1562
Mailing Address - Country:US
Mailing Address - Phone:859-533-0914
Mailing Address - Fax:855-228-0452
Practice Address - Street 1:122 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1903
Practice Address - Country:US
Practice Address - Phone:859-533-0914
Practice Address - Fax:855-228-0452
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAC96171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist