Individual
CHRISTINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
200 MICHELLE LN APT 310, GROTON, CT 06340-4235
(630) 453-7497
Mailing address
200 MICHELLE LN APT 310, GROTON, CT 06340-4235
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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