Individual
DAVID A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1460 MICHAELS RD, TIPP CITY, OH 45371-2030
(937) 430-5647
Mailing address
1460 MICHAELS RD, TIPP CITY, OH 45371-2030
(937) 430-5647
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5504761
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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