| Moulton Chiropractic | |
|
621 N Main St, Suite 415 & 440, Grapevine, TX 76051-9213 | |
| (402) 577-0566 | |
| Not Available |
| Full Name | Moulton Chiropractic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 621 N Main St, Grapevine, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972037505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 13431 (Texas) | Primary |
| Provider Name | Kael Marie Moulton |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568902047 PECOS PAC ID: 8123452604 Enrollment ID: I20191217001794 |
| Provider Name | Nathaniel Alan Worden |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285255828 PECOS PAC ID: 4284065947 Enrollment ID: I20200512003749 |
| Mailing Address | Practice Location Address |
|---|---|
| Moulton Chiropractic 2524 Bear Haven Dr, Grapevine, TX 76051-3880 Ph: (402) 577-0566 | Moulton Chiropractic 621 N Main St, Suite 415 & 440, Grapevine, TX 76051-9213 Ph: (402) 577-0566 |
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