Individual
FRED OLIVER MOORE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1995 GENTILLY BLVD, NEW ORLEANS, LA 70119-1700
(504) 944-0453
Mailing address
2043 ST. NICK DR/P: G4 N4, DURING THE 12 MONTHS DURING, NEW ORLEANS, LA 70131
(504) 512-2120
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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