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Individual

JOHN WAYNE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1001 E BOGARD RD, WASILLA, AK 99654-7114
(907) 373-2225
(907) 376-9225
Mailing address
1001 E BOGARD RD, WASILLA, AK 99654-7114
(907) 373-2225
(907) 376-9225

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
508
AK
363AM0700X
Medical Physician Assistant

Other

Enumeration date
10/16/2006
Last updated
07/01/2024
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