Individual
PHYLLIS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
500 E WASHINGTON ST, ROCHESTER, PA 15074-1956
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN033089L
PA
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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