Individual
CRYSTAL CHANTEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2260 PAR LN, H 911, WILLOUGHBY HILLS, OH 44094-2966
(910) 546-7997
Mailing address
2260 PAR LN, H 911, WILLOUGHBY HILLS, OH 44094-2966
(910) 546-7997
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
161915
OH
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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