Provider Demographics
NPI:1801643473
Name:MOJA FUNCTIONAL HEALTH, LLC
Entity type:Organization
Organization Name:MOJA FUNCTIONAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOJA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-640-7920
Mailing Address - Street 1:175 DAYDREAM AVE APT 6309
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-5479
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 DAYDREAM AVE APT 6309
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-5479
Practice Address - Country:US
Practice Address - Phone:719-640-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty