Individual
EUN JUNG MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3350 THOMAS ST, SPC 100, FAIRBANKS, AK 99709-3828
(907) 457-3110
Mailing address
3350 THOMAS ST, SPC 100, FAIRBANKS, AK 99709-3828
(907) 457-3110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6350
AK
Other
Enumeration date
09/14/2009
Last updated
01/19/2017
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