Individual
MARQUINCIO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
624 FOREST HILL RD APT A1, MACON, GA 31210-4608
(478) 228-6269
Mailing address
624 FOREST HILL RD APT A1, MACON, GA 31210-4608
(478) 228-6269
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN104478
GA
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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