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Individual

JOHN R MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN. CNP

Contact information

Practice address
718 N MACOMB ST, MONROE, MI 48162-7815
(419) 708-8228
Mailing address
7012 CLOISTER RD, TOLEDO, OH 43617-2208
(419) 708-8228

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
0032642
OH
2084P0800X
Psychiatry Physician
Primary
0032642
OH

Other

Enumeration date
01/30/2023
Last updated
01/30/2023
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