Individual
ALEXANDRA ROSE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 36TH ST E, TIFTON, GA 31794-1522
(229) 326-9517
Mailing address
915 36TH ST E, TIFTON, GA 31794-1522
(229) 326-9517
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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