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Dr. Stacia Adair Moore

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NPI Number Detailed Information

Provider Information:

Name: Dr. Stacia Adair Moore
Gender: F
Provider License Number If Given: AU795

NPI Information:

NPI: 1851394902
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 10/20/2011

Provider Business Mailing Address:

Address: 10 THREE MILE DR
Kalispell, MT 59901
Phone Number: 4062572273
Fax Number: 4062577755

Provider Business Practice Location Address:

Address: 10 THREE MILE DR
Kalispell, MT 59901
Phone Number: 4062572273
Fax Number: 4062577755

Provider Taxonomy:

Primary: 231H00000X
Secondary (if any):
State: MT