Individual
DWAYNE MOMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11711 SERENITY LN, INDIANAPOLIS, IN 46229-3966
(317) 927-8836
Mailing address
11711 SERENITY LN, INDIANAPOLIS, IN 46229-3966
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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