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1780823575
RAY A MOORE
PUEBLO, CO
NPI
1780823575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO 6281)
Enumeration Date
2009-02-18
Last Update Date
2009-02-18
Business Address
-- RAY A MOORE CAC III
310 W C ST
PUEBLO, CO 81003-3409
Phone number: 719-296-1366
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Mailing Address
-- RAY A MOORE CAC III
310 W C ST
PUEBLO, CO 81003-3409
Phone number: 719-296-1366
Copy
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