Individual
KEADRIC MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11401 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2349
(888) 515-1793
Mailing address
1603 STAFFORD AVE, LOUISVILLE, KY 40216-2774
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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