Individual
RILEY DALE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19555 N 59TH AVE, GLENDALE, AZ 85308-6813
(623) 572-3200
Mailing address
6125 E INDIAN SCHOOL RD APT 249, SCOTTSDALE, AZ 85251-5496
(641) 590-6259
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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