SearchNew Mexico101YA0400X

Dustin Moore, LSAA

NPI 1639674823 · on the registry since 2018

Practice

Address
511 E 20th St
Farmington, NM 87401
Phone
(505) 564-3733
Clinicians at this address
6

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
NM
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-03-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico