Individual
KRISTEN NICHOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2 S ROWE ST, PRYOR, OK 74361-4623
(918) 825-8022
Mailing address
27300 E 330 RD, BIG CABIN, OK 74332-8337
(918) 418-9782
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3086
OK
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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