Individual
MRS. ELIZABETH MARIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
899 BARKS AVE, MARION, OH 43302-7182
(740) 382-5317
Mailing address
899 BARKS AVE, MARION, OH 43302-7182
(740) 382-5317
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN131531
OH
Other
Enumeration date
03/05/2011
Last updated
03/05/2011
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