Individual
RAPHAEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1642 W AVENUE J, LANCASTER, CA 93534-2814
(661) 942-8463
Mailing address
42422 MARSUERITE WAY, LANCASTER, CA 93536-4561
(323) 240-6237
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2102
CA
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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