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Jacob Moore
NPI 1730819921 · on the registry since 2022 · sole proprietor
Practice
- Address
- 1800 W 30th St
Joplin, MO 64804 - Phone
- (417) 347-7580
- Organisation at this address
- Four State Regional Dialysis Center, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 35
Additional practice sites
- 204 N Lincoln St, Neosho, MO
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-06-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri