Individual
MR. JERRY DON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBP
Contact information
Practice address
7 N 8TH ST, DUNCAN, OK 73533-4601
(580) 475-7162
Mailing address
1315 W CEDAR AVE, DUNCAN, OK 73533-4057
(580) 475-7162
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0142
OK
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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