Individual
REGINALD WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3808 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4502
(720) 248-7099
Mailing address
3908 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4504
(720) 248-7099
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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