Individual
MR. JAMES KNOBLE MOORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
10247 E COVINGTON ST, TUCSON, AZ 85748-2146
(520) 290-9055
(520) 748-1458
Mailing address
1161 N EL DORADO PL STE 103, TUCSON, AZ 85715-4607
(520) 748-7108
(520) 748-1458
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
4698
AZ
385HR2055X
Child Mental Illness Respite Care
4698
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
754871
—
AZ
Enumeration date
10/06/2006
Last updated
05/03/2021
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