Provider Demographics
NPI:1558340547
Name:MOORE, ALISON R (PA C)
Entity Type:Individual
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First Name:ALISON
Middle Name:R
Last Name:MOORE
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Gender:F
Credentials:PA C
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Mailing Address - Street 1:120 E 2ND ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1537
Mailing Address - Country:US
Mailing Address - Phone:814-456-8980
Mailing Address - Fax:814-451-0443
Practice Address - Street 1:120 E 2ND ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1537
Practice Address - Country:US
Practice Address - Phone:814-456-8980
Practice Address - Fax:814-451-0443
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMA052254363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant