Individual
JAMIE L MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 COMMERCIAL ST, BROCKTON, MA 02302-3101
(617) 935-5404
Mailing address
176 LINWOOD ST, BROCKTON, MA 02301-5626
(617) 935-5404
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
S659949987
MA
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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