Jacob Moore, PA-C
NPI #1851780928 in New Brighton, Minnesota
Provider Information
- NPI Number
- 1851780928
- Entity Type
- Individual
- Name
- Jacob Moore, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jan 13, 2015
- Last Updated
- Apr 27, 2015
Practice Location
- Address
- 1900 SILVER LAKE RD NW
- Address 2
- SUITE 110
- City
- New Brighton
- State
- Minnesota
- ZIP Code
- 55112-1786
- Phone
- (651) 628-9566
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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