Individual
SERGELEEN J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 SWEETSPIRE LN, BYRON, GA 31008-5157
(478) 320-8810
Mailing address
111 SWEETSPIRE LN, BYRON, GA 31008-5157
(478) 320-8810
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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