Individual
MEREDITH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA
Contact information
Practice address
114 ROGERS DR, NETTLETON, MS 38858-6014
(662) 614-4803
Mailing address
114 ROGERS DR, NETTLETON, MS 38858-6014
(662) 614-4803
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136001058
VA
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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