KENNETH SHEPPARD MOORE

SAN DIEGO, CA
NPI1568963627
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2018-02-23
Last Update Date2018-02-23
Business Address
KENNETH SHEPPARD MOORE
34800 BOB WILSON DR
SAN DIEGO, CA 92134-1098
Phone number: 757-968-8770
Mailing Address
KENNETH SHEPPARD MOORE
3385 DRAYTON LN
SAN DIEGO, CA 92123-2048
Phone number: 757-256-8311
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