Individual
KENNETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 CHURCHILL HUBBARD RD, SUITE A, YOUNGSTOWN, OH 44505-1371
(330) 759-3040
Mailing address
2119 KIMMEL ST, YOUNGSTOWN, OH 44505-3827
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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