Individual
COURTNEY MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3852 W 370 RD, ADAIR, OK 74330-2792
(918) 782-8988
Mailing address
3852 W 370 RD, ADAIR, OK 74330-2792
(918) 782-8988
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
37V533161114
OK
Other
Enumeration date
04/15/2016
Last updated
04/15/2016
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