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1013961804
BRIAN LEE MOORE
WICHITA, KS
NPI
1013961804
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: KS 54974)
Enumeration Date
2006-05-19
Last Update Date
2007-07-08
Business Address
Mr. BRIAN LEE MOORE CRNA
6615 BRIARWOOD CIR
WICHITA, KS 67212-2986
Phone number: 316-729-4474
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Mailing Address
Mr. BRIAN LEE MOORE CRNA
6615 BRIARWOOD CIR
WICHITA, KS 67212-2986
Phone number: 316-729-4474
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