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1407122401
JONATHAN MOORE
LITHONIA, GA
NPI
1407122401
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-03-24
Last Update Date
2012-03-24
Business Address
-- JONATHAN MOORE
8075 MALL PKWY STE. 101-334
LITHONIA, GA 30038-6993
Phone number: 678-508-1935
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Mailing Address
-- JONATHAN MOORE
2542 YOUNG RD
STONE MOUNTAIN, GA 30088-4204
Phone number: 678-508-1935
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