Provider Demographics
NPI:1821297979
Name:MOYER, RANDAL JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDAL
Middle Name:JAMES
Last Name:MOYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:RANDY
Other - Middle Name:
Other - Last Name:MOYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:331 14TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5040
Mailing Address - Country:US
Mailing Address - Phone:303-922-2977
Mailing Address - Fax:303-922-2044
Practice Address - Street 1:50 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2044
Practice Address - Country:US
Practice Address - Phone:303-922-2977
Practice Address - Fax:303-922-2044
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6073111N00000X, 111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician