Individual
MRS. AMANDA ELISABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 N PITTSBURGH ST, SUITE 3A, CONNELLSVILLE, PA 15425-3233
(724) 628-4450
(724) 626-2580
Mailing address
201 N PITTSBURGH ST, SUITE 3A, CONNELLSVILLE, PA 15425-3233
(724) 628-4450
(724) 626-2580
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA055051
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA055051
STATE LICENSE
PA
Enumeration date
08/02/2011
Last updated
08/11/2011
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