Individual
JERRY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6116 CAMROSE DR, ANCHORAGE, AK 99504-3227
(907) 830-6152
Mailing address
6116 CAMROSE DR, ANCHORAGE, AK 99504-3227
(907) 830-6152
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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