Tavarius Jerrell Moore
NPI #1104384262 in Burlington, North Carolina
Provider Information
- NPI Number
- 1104384262
- Entity Type
- Individual
- Name
- Tavarius Jerrell Moore
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Mar 7, 2019
- Last Updated
- Mar 7, 2019
Practice Location
- Address
- 206 FRIENDLY RD
- City
- Burlington
- State
- North Carolina
- ZIP Code
- 27217-2502
- Phone
- (804) 624-3515
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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