Individual
HARLEY NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 14TH AVE SE, DECATUR, AL 35601-3314
(256) 341-7162
Mailing address
710 14TH AVE SE, DECATUR, AL 35601-3314
(256) 341-7162
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12707
AL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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