Individual
MRS. TERRIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 314-7602
(757) 314-7601
Mailing address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(706) 562-4348
(757) 314-7601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005591
GA
363A00000X
Physician Assistant
Primary
010002446
VA
Other
Enumeration date
06/21/2007
Last updated
04/14/2026
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