Individual
LARONDA K MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
22826 COACHLIGHT CIR, TAYLOR, MI 48180-6398
(313) 721-7916
Mailing address
22826 COACHLIGHT CIR, TAYLOR, MI 48180-6398
(313) 721-7916
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113167
MI
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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