Individual
MATTHEW DOUGLAS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
88 SPARKLEBERRY LN E, DALLAS, GA 30132-7578
(770) 605-7982
Mailing address
88 SPARKLEBERRY LN E, DALLAS, GA 30132-7578
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN266385
GA
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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