Individual
JENNA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1363 COAL DOCK RD, WAVERLY, OH 45690-9744
(740) 970-7020
Mailing address
1363 COAL DOCK RD, WAVERLY, OH 45690-9744
(740) 970-7020
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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