Provider Demographics
NPI:1730833708
Name:MOJA, LUKE (DC)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:MOJA
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 1:175 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:719-640-7920
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:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor