Individual
LARRY EUGENE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
230 HOSPITAL PLAZA, WESTON, WV 26452-8558
(304) 269-8000
(304) 269-8090
Mailing address
230 HOSPITAL PLAZA, WESTON, WV 26452-8558
(304) 269-8000
(304) 269-8090
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
31593
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065546000
—
WV
Enumeration date
09/13/2006
Last updated
07/08/2007
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