Individual
JACOB A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 W 30TH ST, JOPLIN, MO 64804-1520
(417) 347-7580
Mailing address
PO BOX 2526, JOPLIN, MO 64803-2526
(417) 347-7579
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2022011251
MO
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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