Individual
MEGAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
39 SPARKS LN, MINFORD, OH 45653-8648
(740) 821-1043
Mailing address
39 SPARKS LN, MINFORD, OH 45653-8648
(740) 821-1043
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401710971214
OH
Other
Enumeration date
11/26/2016
Last updated
11/26/2016
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