Individual
FELICIA SANDRA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6599 S BROADWAY, IDLEWILD, MI 49642-9577
(231) 408-6200
Mailing address
6599 S BROADWAY, IDLEWILD, MI 49642-9577
(231) 408-6200
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/27/2020
Last updated
06/27/2020
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