Individual
MR. JUSTIN MOORE
Active
Individual
MR. JUSTIN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
346971
LA
Other
Enumeration date
07/30/2019
Last updated
05/23/2025
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