Individual
DR. ELLIOTT MATTHEW MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 15TH ST # GC5114, AUGUSTA, GA 30912-0004
(706) 721-2411
Mailing address
1120 15TH ST # GC5114, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/24/2026
Last updated
02/24/2026
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