Individual
BREANNA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15946 MCLANE PIKE, LIBERTY, WV 25124
(304) 932-7562
Mailing address
15946 MCLANE PIKE, LIBERTY, WV 25124
(304) 932-7562
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
05/10/2022
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