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Individual

MRS. SHELLY M MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.P.M.

Contact information

Practice address
696 ROY GRIDER RD, SUMMER SHADE, KY 42166-7631
(270) 590-8513
Mailing address
696 ROY GRIDER RD, SUMMER SHADE, KY 42166-7631
(270) 590-8513

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary

Other

Enumeration date
08/23/2013
Last updated
08/23/2013
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