Individual
HALEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
513 N MAIN ST, ANNA, IL 62906-1697
(618) 833-4471
(618) 833-6267
Mailing address
513 N MAIN ST, ANNA, IL 62906-1697
(618) 833-4471
(618) 833-6267
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009259
IL
Other
Enumeration date
09/26/2022
Last updated
11/13/2023
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