JACQUELINE HISTORIAN MOORE

LITHONIA, GA
NPI1659649002
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: GA  LPN085771)
Enumeration Date2011-12-13
Last Update Date2014-01-22
Business Address
-- JACQUELINE HISTORIAN MOORE LPN
6256 HILLANDALE DR APT 803
LITHONIA, GA 30058-2432
Phone number: 678-913-7277
Mailing Address
-- JACQUELINE HISTORIAN MOORE LPN
6256 HILLANDALE DR APT 803
LITHONIA, GA 30058-2432
Phone number: 678-913-7277
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