NPI 1104781962
Kendrick Lamar Moore
Practice location
- Address
- 6624 Rustic Ridge Trl, Grand Blanc, MI 48439-4955
- Phone
- (833) 478-9464
- Fax
- (810) 462-1093
Registered specialties
Community Health Worker
Primary
Registry record
- NPI
- 1104781962
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 23 Dec 2025
- Record last updated
- 23 Dec 2025
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.