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1285418848
CHARLES KEITH MOON
DANVILLE, VA
NPI
1285418848
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024187950)
Enumeration Date
2023-08-23
Last Update Date
2023-08-23
Business Address
Mr. CHARLES KEITH MOON FNP
2344 RIVERSIDE DR
DANVILLE, VA 24540-4212
Phone number: 434-791-3800
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Mailing Address
Mr. CHARLES KEITH MOON FNP
1111 S JEFFERSON ST
ROANOKE, VA 24016-4724
Phone number: 540-769-3964
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