Individual
CHARLES TYREE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD, LD
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-1347
Mailing address
438 BRIGHAM TRL, AUGUSTA, GA 30909-6045
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5813
GA
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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