Individual
MR. FREDERICK HENRY MOORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14000 LAKESIDE CIR, STERLING HEIGHTS, MI 48313-1320
(586) 260-6371
Mailing address
38511 WELLINGTON DR, CLINTON TOWNSHIP, MI 48036-3520
(586) 260-6371
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
2701493343
MI
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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