Individual
FAITH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20332 EUREKA RD STE B, TAYLOR, MI 48180-5310
(734) 285-6767
Mailing address
465 PINE ST, WYANDOTTE, MI 48192-6237
(734) 285-8921
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501009510
LICENSE
MI
Enumeration date
08/29/2006
Last updated
07/08/2007
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