Individual
WANDA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 N COURT AVE, COVINGTON, VA 24426-1534
(540) 691-5248
Mailing address
140 N COURT AVE, COVINGTON, VA 24426-1534
(540) 691-5248
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
07/21/2022
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