Individual
DR. SUSAN ELISABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 W GLEN ST, CRANDON, WI 54520-1355
(715) 478-3318
(715) 478-3255
Mailing address
400 W GLEN ST, CRANDON, WI 54520-1355
(715) 478-3318
(715) 478-3255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45505
WI
Other
Enumeration date
08/23/2006
Last updated
05/07/2012
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