Individual
HOLLY S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 ANTHONY WAYNE DR, SUITE 115, DETROIT, MI 48202-3945
(313) 577-5041
Mailing address
5200 ANTHONY WAYNE DR, SUITE 115, DETROIT, MI 48202-3945
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704222396
MI
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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