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Individual

MISS CAROLYN BRUNETTE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7912 DUBLIN FRST, SAN ANTONIO, TX 78253-4444
(901) 585-1593
Mailing address
7912 DUBLIN FRST, SAN ANTONIO, TX 78253-4444
(901) 585-1593
(707) 652-1112

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
804920727
TX

Other

Enumeration date
01/27/2023
Last updated
07/07/2023
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