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1861762809
IAN JOSEPH MOORE
MEDFORD, OR
NPI
1861762809
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-01-09
Last Update Date
2012-01-09
Business Address
-- IAN JOSEPH MOORE peer support special
1911 HAZEL AVE
MEDFORD, OR 97501
Phone number: 541-734-3951
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Mailing Address
-- IAN JOSEPH MOORE peer support special
1911 HAZEL ST.
MEDFORD, OR 97501
Phone number: 541-734-3951
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