Organization
MOORE SURGICAL ASSISTANT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L MOORE CST/CSFA (PREISDENT)
(770) 842-1857
Entity
Organization
Contact information
Practice address
80 MOORE RD, KINGSTON, GA 30145-2619
(770) 842-1857
(770) 606-0600
Mailing address
80 MOORE RD, KINGSTON, GA 30145-2619
(770) 842-1857
(770) 606-0600
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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