Individual
GERALD DWAYNE MOORE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(770) 878-7794
Mailing address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(770) 878-7794
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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