Individual
MATTHEW THOMAS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
200 UNIVERSITY RDG, GREENVILLE, SC 29601-3635
(864) 372-3198
Mailing address
62 KIRKWOOD LN, GREENVILLE, SC 29607-1113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
236506
SC
Other
Enumeration date
05/25/2017
Last updated
05/25/2017
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