Individual
BRENDA KAY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1253
Mailing address
825 OUTLAW RD UNIT 73, CHURCH ROCK, NM 87311-0014
(832) 686-1965
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
009519
AZ
Other
Enumeration date
04/27/2011
Last updated
07/23/2024
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