Provider Demographics
NPI:1528142254
Name:MOESER, RACHEL ELENA (DC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELENA
Last Name:MOESER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4395 OLD HAMILTON MILL RD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8816
Mailing Address - Country:US
Mailing Address - Phone:770-614-3018
Mailing Address - Fax:
Practice Address - Street 1:4330 S LEE ST
Practice Address - Street 2:SUITE 100A
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518
Practice Address - Country:US
Practice Address - Phone:770-614-3018
Practice Address - Fax:770-614-4423
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U9278Medicare UPIN
GA35ZCHJTMedicare PIN