Individual
FERNANDO MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2241 NW 31ST ST, OKLAHOMA CITY, OK 73112-7907
(337) 422-2616
Mailing address
2241 NW 31ST ST, OKLAHOMA CITY, OK 73112-7907
(337) 422-2616
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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