Individual
AMY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5512 BIG TYLER RD, CROSS LANES, WV 25313-1304
(304) 766-9830
Mailing address
5512 BIG TYLER RD, CROSS LANES, WV 25313-1304
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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