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Ebonie Moore
NPI 1861041865 · on the registry since 2019
Practice
- Address
- 3538 Lantern View Ln
Scottdale, GA 30079 - Phone
- (470) 269-4271
Registry record
- Primary taxonomy
- Contractor
171W00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-09-11
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 Georgia