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Molly Marie Moore

Student in an Organized Health Care Education/Training Program in Atoka, OK. Individual provider (NPI-1).

NPI number1962007690
StatusActive
Last updated in NPPESDec 1, 2020

Details

NPI
1962007690
Entity type
Individual (NPI-1)
Name
Molly Marie Moore
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 1, 2020
Certification date
Nov 30, 2020
Last updated
Dec 1, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

1680 S Greathouse Drive
Atoka, OK 74525

Phone 580-297-6965 · Fax 580-324-4181

Mailing address

1680 S Greathouse Drive
Atoka, OK 74525

Phone 580-297-6965 · Fax 580-324-4181

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Other Student in an Organized Health Care Education/Training Program providers in Atoka, OK

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