Individual
LUNDRIA S MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3918 W CLINTON AVE, MILWAUKEE, WI 53209-1944
(414) 551-7367
(414) 551-7368
Mailing address
3918 W CLINTON AVE, MILWAUKEE, WI 53209-1944
(414) 551-7367
(414) 551-7368
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305909-031
WI
Other
Enumeration date
12/04/2010
Last updated
12/04/2010
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