Shelathum Moore

NPI #1215647573 in Fairburn, Georgia

Provider Information

NPI Number: 1215647573
Entity Type: Individual
Name: Shelathum Moore
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Nov 28, 2022
Last Updated: Nov 28, 2022

Practice Location

Address: 670 BIRKDALE DR
City: Fairburn
State: Georgia
ZIP Code: 30213-2924
Phone: (678) 929-1123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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