Search › Pennsylvania › 1041C0700X
Sam Moore
NPI 1720651433 · on the registry since 2021 · sole proprietor
Practice
- Address
- 5906 Langdon St
Philadelphia, PA 19149 - Phone
- (580) 445-7432
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-07-20
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 Pennsylvania