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1386035954
TIM I MOOMAW
GALLIPOLIS, OH
NPI
1386035954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: OH COA.17111-NP)
Enumeration Date
2015-02-18
Last Update Date
2015-02-18
Business Address
-- TIM I MOOMAW NP
100 JACKSON PIKE
GALLIPOLIS, OH 45631-1560
Phone number: 740-446-5000
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Mailing Address
-- TIM I MOOMAW NP
75 REMIT DR #1367
CHICAGO, IL 60675-1367
Phone number: 866-916-5259
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