Individual
MARCUS ANTWONE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1825 PARKER RD SE APT 105, CONYERS, GA 30094-2644
(404) 547-9678
Mailing address
1825 PARKER RD SE APT 105, CONYERS, GA 30094-2644
(404) 547-9678
Taxonomy
Speciality
Code
Description
License number
State
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
Primary
007330
GA
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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