NICHOLAS SCOTT MOON

PADUCAH, KY
NPI1407138811
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2011-09-12
Last Update Date2011-09-12
Business Address
-- NICHOLAS SCOTT MOON
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number: 270-442-7121
Mailing Address
-- NICHOLAS SCOTT MOON
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number:
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