Individual
MICHAEL D MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8846 S REDWOOD RD STE E121, WEST JORDAN, UT 84088-9366
(801) 569-1999
Mailing address
PO BOX 198560, ATLANTA, GA 30384-8560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11004975-4405
UT
Other
Enumeration date
05/17/2024
Last updated
06/02/2025
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