Individual
BEVERLY A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
830 DAYSPRING CT, TRENTON, OH 45067-9629
(706) 495-2735
Mailing address
830 DAYSPRING CT, TRENTON, OH 45067-9629
(706) 495-2735
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 137552
OH
Other
Enumeration date
02/18/2013
Last updated
02/18/2013
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