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Individual
MR. JEROME MOORE
Active
Individual
MR. JEROME MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E029658
GA
261QA0600X
Adult Day Care Clinic/Center
—
NULL
376K00000X
Nurse's Aide
CN0030028021
GA
Other
Enumeration date
06/29/2014
Last updated
02/20/2020
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