Individual
JIMMY MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16541 SWEETWATER DR, MILTON, DE 19968-3062
(302) 500-0950
Mailing address
16541 SWEETWATER DR, MILTON, DE 19968-3062
(302) 500-0950
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
2015102773
DE
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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