Individual
GRACE ELLEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
5126 W DAYBREAK PKWY, SOUTH JORDAN, UT 84009-5994
(443) 299-9623
Mailing address
1305 N VALENTINE ST, SALT LAKE CITY, UT 84116-3627
(443) 299-9623
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86051484
MD
Other
Enumeration date
10/30/2020
Last updated
03/13/2024
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