| Brenda K Moore Do Pa | |
|
1003 College Blvd W Suite #2 Niceville FL 32578-1068 | |
| (850) 678-0443 | |
| Not Available |
| Full Name | Brenda K Moore Do Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 1003 College Blvd W, Niceville, Florida |
| Authorized Official Name and Position | Brenda Kay Moore (PRESIDENT) |
| Authorized Official Contact | 8326861965 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda K Moore Do Pa 1003 College Blvd W Suite #2 Niceville FL 32578-1068 Ph: (850) 678-0443 | Brenda K Moore Do Pa 1003 College Blvd W Suite #2 Niceville FL 32578-1068 Ph: (850) 678-0443 |
| NPI Number | 1255733986 |
|---|---|
| Provider Enumeration Date | 09/25/2014 |
| Last Update Date | 09/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255733986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OS 12957 (Florida) | Primary |
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