Organization
MOORE SURGICAL ASSISTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JONATHAN MOORE CSFA (PRESIDENT)
(970) 629-2135
Entity
Organization
Contact information
Practice address
674 MESA CT, RIFLE, CO 81650-2529
(970) 629-2135
(888) 329-6432
Mailing address
PO BOX 602, RIFLE, CO 81650-0602
(970) 629-2135
(888) 329-6432
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124936
CSFA CERTIFICATE
CO
Enumeration date
03/28/2013
Last updated
07/30/2015
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