Individual
JEFFREY EDWARD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
213 W THIRD AVE, SUITE 106, WARREN, PA 16365
(814) 723-4470
(814) 723-5413
Mailing address
213 W THIRD AVE, SUITE 106, WARREN, PA 16365
(814) 723-4470
(814) 723-5413
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0EG000559
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M01647445
PA BLUE SHIELD
PA
Enumeration date
05/23/2006
Last updated
01/28/2008
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