Individual
MORGAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
156 S JACKSON AVE, AZUSA, CA 91702-4254
(916) 662-6297
Mailing address
156 S JACKSON AVE, AZUSA, CA 91702-4254
(916) 662-6297
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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