Individual
DEREK MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15024 MORMON ST, BENNINGTON, NE 68007-1246
(402) 889-3140
Mailing address
15024 MORMON ST, BENNINGTON, NE 68007-1246
(402) 889-3140
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/20/2020
Last updated
06/20/2020
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