Individual
JACOB MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Contact information
Practice address
116 WARD SPORTS MEDICINE BUILDING, GREENVILLE, NC 27858
(252) 737-2634
(252) 737-1393
Mailing address
316 PRINCE RD, GREENVILLE, NC 27858-4941
(252) 737-2634
(252) 737-1393
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1166
NC
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
About Stedi
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