Individual
MISS COLEEN MICHELE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 S PINE ST, PRATT, KS 67124-2739
(620) 786-8826
Mailing address
3320 MEADOWLARK LN, GREAT BEND, KS 67530-7539
(620) 786-8826
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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