Individual
HAROLD MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
377 LEAF TRAIL LN, CORDOVA, TN 38018-7448
(901) 761-1853
Mailing address
377 LEAF TRAIL LN, CORDOVA, TN 38018-7448
(901) 761-1853
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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