Individual
OLIVIA NICOLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1333 TAYLOR ST STE 6F, COLUMBIA, SC 29201-2953
(803) 296-3273
(803) 296-7061
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-5603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4894
SC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/18/2023
Last updated
06/28/2023
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