Organization
SMR SERVICES LLC
Active
Organization
SMR SERVICES LLC
Active
Other names
SUSAN M MOORE-RIESBECK DO
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RIESBECK (ACCOUNTANT)
(574) 993-4464
Entity
Organization
Contact information
Practice address
28070 COUNTY ROAD 24, ELKHART, IN 46517-9717
(574) 273-8053
(574) 273-8056
Mailing address
PO BOX 175, GRANGER, IN 46530-0175
(574) 273-8053
(574) 273-8056
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
11/07/2019
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