Individual
HEIDI MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 N 5TH AVE, ANTHONY, KS 67003-2106
(620) 491-0525
Mailing address
316 N WOLF ST, CHENEY, KS 67025-8990
(620) 727-5237
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01436
KS
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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