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1760767610
LACIE STAFFORD MOORE
LAFAYETTE, LA
NPI
1760767610
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA PA.200503)
Enumeration Date
2011-10-11
Last Update Date
2018-03-17
Business Address
Mrs. LACIE STAFFORD MOORE PA-C
4600 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508-6902
Phone number: 337-521-9127
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Mailing Address
Mrs. LACIE STAFFORD MOORE PA-C
4600 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508-6902
Phone number: 337-521-9127
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