Individual
KENDRICK LAMAR MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6624 RUSTIC RIDGE TRL, GRAND BLANC, MI 48439-4955
(833) 478-9464
(810) 462-1093
Mailing address
6624 RUSTIC RIDGE TRL, GRAND BLANC, MI 48439-4955
(833) 478-9464
(810) 462-1093
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/23/2025
Last updated
12/23/2025
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