Individual
CLIFFORD WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
633 LASHLEY ST, MORGANTOWN, WV 26505-2429
(304) 290-9246
Mailing address
633 LASHLEY ST, MORGANTOWN, WV 26505-2429
(304) 290-9246
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00805790074
—
WV
Enumeration date
08/18/2020
Last updated
08/18/2020
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