Individual
GREGORY KIM MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
1317 N COURT ST, OTTUMWA, IA 52501-1911
(641) 683-3277
(641) 683-3458
Mailing address
1317 N COURT ST, OTTUMWA, IA 52501-1911
(641) 683-3277
(641) 683-3458
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
291,122
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0168054
—
IA
Enumeration date
01/10/2007
Last updated
07/08/2007
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