Individual
DR. MICHELLE ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O. D.
Contact information
Practice address
683 BROAD ST, BRISTOL, CT 06010-6662
(860) 583-2020
Mailing address
11 CROWN ST, PLAINVILLE, CT 06062-2214
(860) 793-1330
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT2482
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0V5039
HNET
CT
01
—
599721
CT. CARE
CT
01
—
906456
BLOCK VISION
CT
Enumeration date
01/25/2006
Last updated
12/07/2007
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