Individual
JOHN MICHAEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1403 E SEGO LILY DR STE 100, SANDY, UT 84092-4350
(801) 265-2212
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 954-7672
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8205692-4405
UT
Other
Enumeration date
08/20/2012
Last updated
06/07/2024
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