Individual
CRYSTAL BAXLEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 EAST BROAD ST, ELIZABETHTOWN, NC 28337
(910) 991-3151
Mailing address
8621 LISBON RD, CLARKTON, NC 28433-8769
(910) 991-3151
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
C48738
NC
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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