Individual
RALPH EDWARD MOORE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
302 PERIMETER CTR N APT 1541, ATLANTA, GA 30346-3422
(619) 884-5531
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN310566
GA
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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