Individual
DR. JAKE T MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1180 N MAIN ST STE 5, BOWLING GREEN, OH 43402-4932
(419) 315-1225
(419) 315-1226
Mailing address
333 N SUMMIT ST FL 7, TOLEDO, OH 43604-1531
(419) 315-1225
(419) 315-1226
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.014671
OH
207Q00000X
Family Medicine Physician
5101022457
MI
Other
Enumeration date
05/31/2016
Last updated
11/03/2023
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