NPI 1164170189
Crystal Moore
Practice location
- Address
- 2115 W Roosevelt Dr, Milwaukee, WI 53209-6323
- Phone
- (414) 207-0551
Registered specialties
Contractor
Primary
Registry record
- NPI
- 1164170189
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 17 Mar 2022
- Record last updated
- 17 Mar 2022
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.