Individual
MOLLIE GAIL MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2303 VINCENT ST, BROWNWOOD, TX 76801-4933
(325) 200-1117
Mailing address
2303 VINCENT ST, BROWNWOOD, TX 76801-4933
(325) 200-1117
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336342
TX
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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