Individual
VERA ELIZABETH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43415 W SUNLAND DR, MARICOPA, AZ 85138-2368
(443) 525-2160
Mailing address
994 S HARRISON RD, TUCSON, AZ 85748-6608
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
7736558
AZ
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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