Individual
DENISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6237 LEDGEWAY DR, WEST BLOOMFIELD, MI 48322-2446
(313) 995-4756
Mailing address
6237 LEDGEWAY DR, WEST BLOOMFIELD, MI 48322-2446
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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