Individual
JAMES BRODERICK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 EVANS AVE, MT STERLING, KY 40353-9700
(859) 498-0011
Mailing address
150 JOHNSTAN ST, OWINGSVILLE, KY 40360-2029
(606) 336-1756
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1940
KY
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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