Individual
TIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6100 E MAIN ST STE 110, COLUMBUS, OH 43213-3399
(614) 861-1120
Mailing address
10535 TOLLGATE RD SW, ETNA, OH 43062-8324
(614) 636-9987
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0040480
OH
Other
Enumeration date
10/04/2025
Last updated
10/04/2025
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