SAM MOORE

CHAMPAIGN, IL
NPI1972516797
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036075380)
Enumeration Date2006-08-14
Last Update Date2013-12-11
Business Address
-- SAM MOORE D.O.
1701 W. CURTIS
CHAMPAIGN, IL 61822-9678
Phone number: 217-365-6203
Mailing Address
-- SAM MOORE D.O.
602 W UNIVERSITY AVE
URBANA, IL 61801-2530
Phone number: 217-383-3311
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