Individual
KYLE M MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3202 E BELLEVUE ST APT 34, TUCSON, AZ 85716-3952
(520) 390-0142
Mailing address
PO BOX 50101, TUCSON, AZ 85703-1101
(520) 390-0142
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2740103
AZ
Other
Enumeration date
03/26/2011
Last updated
03/26/2011
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