ROGER MOORE

WAVERLY, OH
NPI1265921316
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2018-05-04
Last Update Date2018-05-04
Business Address
ROGER MOORE
14572 US HIGHWAY 23 STE A
WAVERLY, OH 45690-9448
Phone number: 740-947-6727
Mailing Address
ROGER MOORE
5484 POND RUN RD UNIT B
STOUT, OH 45684-8002
Phone number: 740-464-9637