Individual
JACOB MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1001 S RAISINVILLE RD, MONROE, MI 48161-9754
(734) 384-0377
Mailing address
1001 S RAISINVILLE RD, MONROE, MI 48161-9754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704313624
MI
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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