Individual
SHANNON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 STATE ST, SUITE 301, ERIE, PA 16507-1427
(814) 877-7907
Mailing address
11279 PERRY HWY, SUITE 450, WEXFORD, PA 15090-9381
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
208000000X
OH
Other
Enumeration date
03/17/2011
Last updated
03/25/2021
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