NPI 1063253136

Raven Moore

Practitioner Phlebotomy Technician Rockmart, GA

Practice location

Address: 154 Chief CT, Rockmart, GA 30153-8020
Phone: (678) 994-6085

Registered specialties

Phlebotomy Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246RP1900X Licence J6G4Z3L9 (GA)

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Registry record

NPI: 1063253136
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Jun 2024
Record last updated: 3 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.