Individual
DR. JARED L MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10607 RANDOLPH ST, CROWN POINT, IN 46307-7504
(262) 366-7994
Mailing address
10607 RANDOLPH ST, CROWN POINT, IN 46307-7504
(262) 366-7994
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
99053018A
IN
213E00000X
Podiatrist
POD001156
GA
Other
Enumeration date
03/28/2012
Last updated
08/17/2012
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