Individual
STACY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 SPRUCE ST, PARSONS, WV 26287-1016
(304) 621-3178
Mailing address
PO BOX 97, HENDRICKS, WV 26271-0097
(304) 621-3178
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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