Individual
REGINA LYNNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA/RA
Contact information
Practice address
RR 3 BOX 4244, DONIPHAN, MO 63935-8473
(573) 996-2669
(573) 996-2669
Mailing address
PO BOX 504, DONIPHAN, MO 63935-0504
(573) 996-2669
(573) 996-2669
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
06MO1254
MO
Other
Enumeration date
03/04/2009
Last updated
03/05/2009
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