Organization
REBECCA L. MOORE MD PROF CO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI A LABRECQUE (ACCOUNTS MGR)
(702) 453-3799
Entity
Organization
Contact information
Practice address
750 HOSPITAL LOOP, CRAIG, CO 81625-8750
(970) 824-9411
Mailing address
21852 E ONTARIO DR, #1427, AURORA, CO 80016-6048
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
29536
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29536
CO LIC
CO
Enumeration date
11/14/2011
Last updated
01/26/2012
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