| NPI | 1174178701 |
|---|---|
| Doing Business As | SUSAN M MOORE-RIESBECK DO |
| Entity Type | Organization |
| Authorized Contact | DAVID RIESBECK Accountant 574-993-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-11-07 |