Individual
ANITA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
81 BENNING PL, DAYTON, OH 45417-3720
(937) 301-0641
Mailing address
81 BENNING PL, DAYTON, OH 45417-3720
(937) 301-0641
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205305
—
OH
Enumeration date
12/16/2020
Last updated
12/16/2020
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