Individual
GERALD MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
417 E 14TH ST, CASPER, WY 82601-4309
(307) 333-3984
Mailing address
417 E 14TH ST, CASPER, WY 82601-4309
(307) 333-3984
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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