Individual
CATHY SHABAZ MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9220 JAMES AVE S STE 1, BLOOMINGTON, MN 55431-4504
(952) 234-5898
Mailing address
7993 172ND ST W, LAKEVILLE, MN 55044-9132
(763) 301-2032
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9909
MN
Other
Enumeration date
10/10/2006
Last updated
09/02/2022
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