Individual
MR. NEDWARD B;AINE MOORE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
220 PLANE RD, PORTAGE, PA 15946-6704
(814) 736-9700
Mailing address
220 PLANE RD, PORTAGE, PA 15946-6704
(814) 736-9700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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