Individual
DR. DEMETRIUS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ND
Contact information
Practice address
612 W CROSSVILLE RD STE 200, ROSWELL, GA 30075-2539
(470) 749-6107
Mailing address
1398 KEYHAVEN CT, LAWRENCEVILLE, GA 30045-2797
(470) 749-6107
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
171400000X
Health & Wellness Coach
—
—
174H00000X
Health Educator
—
—
175F00000X
Naturopath
Primary
—
—
175L00000X
Homeopath
—
—
225100000X
Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
01/22/2025
Last updated
01/29/2025
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