Individual
JENNIFER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
285 CHURCH ST, CLAY, WV 25043-9413
(304) 587-4266
Mailing address
501 22ND ST, DUNBAR, WV 25064-1711
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
50699
WV
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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