Individual
MICHAEL ELIAS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 VALLEY DR, PAULS VALLEY, OK 73075-6613
(405) 242-1618
Mailing address
515 E GRANT AVE, PAULS VALLEY, OK 73075-2636
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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