Individual
CHARLES MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3044 ASHLY FOREST DR, SNELLVILLE, GA 30078-4524
(770) 875-0556
Mailing address
3044 ASHLY FOREST DR, SNELLVILLE, GA 30078-4524
(770) 875-0556
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
CN0030004589
GA
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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