Individual provider · Type 1 NPI
Gerry Delayne Moore Sr.
Driver · Baxley, GA
NPI number
1164773040
Active
Practice location
85 Rendi Ln
Baxley, GA 31513-6816
Fax (912) 367-0986
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | None listed |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
Another provider at this address
About NPI 1164773040
Gerry Delayne Moore Sr.'s National Provider Identifier is 1164773040, issued on Oct 2, 2012. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Baxley, GA. The record was last updated on Oct 2, 2012.