Individual
VERNICE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14030 LAKESIDE BLVD N, BLDG C APT 230, SHELBY TOWNSHIP, MI 48315-6050
(313) 574-3093
Mailing address
14030 LAKESIDE BLVD N, BLDG C APT 230, SHELBY TOWNSHIP, MI 48315-6050
(313) 574-3093
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
247200000X/T
MI
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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