Individual
JAMES MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
129 CANNON TRAIL RD, LEXINGTON, SC 29073-7976
(803) 920-6758
Mailing address
129 CANNON TRAIL RD, LEXINGTON, SC 29073-7976
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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