Individual
DAVID MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1165 WALMART WAY, RADCLIFF, KY 40160-1471
(270) 351-3937
(270) 352-2756
Mailing address
1165 WALMART WAY, RADCLIFF, KY 40160-1471
(270) 351-3937
(270) 352-2756
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1206DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77012060
—
KY
Enumeration date
07/07/2005
Last updated
02/12/2015
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