Individual
MR. MICHALL ALAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, MED, LAC, NCC
Contact information
Practice address
2843 S 48TH WAY, YUMA, AZ 85364-9611
(928) 580-9725
Mailing address
2843 S. 48TH WAY, YUMA, AZ 85364-2843
(928) 580-9725
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
LAC-12325
AZ
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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