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General NPI Number Information
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NPI Number | 1659110963
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Entity Type | Organization
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Legal Business Name | MOORE MOTIVATION PC LLC
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1541 U.S. 19 SOUTH
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City | LEESBURG
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State | GA
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Zip | 31763
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Country | US
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Telephone | 229-886-3739
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Fax |
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Provider Business Mailing Address
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Address Line | 155 BALMORAL DR
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City | LEESBURG
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State | GA
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Zip | 31763-7506
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Country | US
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Telephone | 917-280-6837
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID JOSEPH MOORE JR.
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Credential |
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Telephone | 917-280-6837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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