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1821512179
JACOB MOORE
GREENVILLE, NC
NPI
1821512179
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC 1166)
Enumeration Date
2017-07-28
Last Update Date
2017-07-28
Business Address
JACOB MOORE ATC LAT
116 WARD SPORTS MEDICINE BUILDING
GREENVILLE, NC 27858
Phone number: 252-737-2634
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Mailing Address
JACOB MOORE ATC LAT
316 PRINCE RD
GREENVILLE, NC 27858-4941
Phone number: 252-737-2634
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