Provider Demographics
NPI:1801009808
Name:MOORE, RONALD ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ERIC
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 1:137 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1109
Mailing Address - Country:US
Mailing Address - Phone:256-464-0522
Mailing Address - Fax:256-464-0544
Practice Address - Street 1:137 HUGHES RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1109
Practice Address - Country:US
Practice Address - Phone:256-464-0522
Practice Address - Fax:256-464-0544
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor