Jacob Bradley Moore

NPI #1063080554 in Columbia, Missouri

Provider Information

NPI Number: 1063080554
Entity Type: Individual
Name: Jacob Bradley Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Enumeration Date: Jun 11, 2021
Last Updated: Jun 11, 2021

Practice Location

Address: 500 N KEENE ST
Address 2: SUITE 103
City: Columbia
State: Missouri
ZIP Code: 65201-8104
Phone: (573) 874-2030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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