Individual
MS. JENNIFER A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1610 Z AVE, LA GRANDE, OR 97850-3745
(541) 910-2046
Mailing address
1610 Z AVE, LA GRANDE, OR 97850-3745
(541) 910-2046
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01183
OR
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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