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Individual

MRS. VICKI LYNN MOORE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CST/CFA

Contact information

Practice address
1409 DUNWOODY PLACE, ATLANTA, GA 30350
(770) 594-1351
(770) 594-1381
Mailing address
80 MOORE RD, KINGSTON, GA 30145-2619
(770) 842-1857
(770) 606-0129

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary

Other

Enumeration date
02/09/2006
Last updated
07/08/2007
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