Individual
ADDISON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 10TH AVE, COLUMBUS, GA 31901-1529
(706) 571-1430
Mailing address
1900 10TH AVE STE 100, COLUMBUS, GA 31901-3601
(706) 571-1430
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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