Individual
DUSTIN RANDALL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
11086 NW PALMETTO BLVD, ALACHUA, FL 32615-6963
(352) 316-3369
Mailing address
473 TURKEY CRK, ALACHUA, FL 32615-9303
(352) 316-3369
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA88614
FL
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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