Individual
MARTINA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 FAYETTE HILLS DR, FAYETTEVILLE, WV 25840-8506
(304) 877-1707
Mailing address
203 FAYETTE HILLS DR, FAYETTEVILLE, WV 25840-8506
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/12/2021
Last updated
02/12/2021
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