Individual
MR. PEDRO SAUL MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
1145 HIGHWAY 42, PETAL, MS 39465-9740
(601) 544-0500
Mailing address
273 MACEDONIA RD, PETAL, MS 39465-9767
(601) 545-8329
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT0038
MS
Other
Enumeration date
12/30/2006
Last updated
07/08/2007
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