Individual
DAVID ALLAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3159 LAKE ROAD, HORSEHEADS, NY 14845
(607) 280-4282
Mailing address
3159 LAKE RD, HORSEHEADS, NY 14845-3117
(607) 280-4282
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
611741718
NY
Other
Enumeration date
07/29/2017
Last updated
07/21/2022
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