Andrew Moulton
Student in an Organized Health Care Education/Training Program in North Chicago, IL. Individual provider (NPI-1).
NPI number1164043626
StatusActive
Last updated in NPPESMay 6, 2020
Details
- NPI
- 1164043626
- Entity type
- Individual (NPI-1)
- Name
- Andrew Moulton
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 6, 2020
- Certification date
- May 6, 2020
- Last updated
- May 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3333 Green Bay RdNorth Chicago, IL 60064-3037
Phone 360-930-2912
Mailing address
3333 Green Bay RdNorth Chicago, IL 60064-3037
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All 172 Student in an Organized Health Care Education/Training Program providers in North Chicago · All 1,166 providers in North Chicago
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