Individual
LISA DIANE MOORE-BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(480) 529-7213
Mailing address
4502 N 2ND DR, PHOENIX, AZ 85013-2912
(480) 529-7213
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
006369
AZ
207P00000X
Emergency Medicine Physician
Q0675
TX
Other
Enumeration date
06/09/2011
Last updated
09/20/2018
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