Individual
ISAAC BENJAMIN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
123 MCNUTTS CREEK CT, ATHENS, GA 30606-3862
(770) 301-7993
Mailing address
123 MCNUTTS CREEK CT, ATHENS, GA 30606-3862
(770) 301-7993
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN199586
GA
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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