Individual
JORDAN N MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5289 WOODBURY LOOP, MORGANTOWN, KY 42261-9302
(270) 999-8159
Mailing address
5289 WOODBURY LOOP, MORGANTOWN, KY 42261-9302
(270) 999-8159
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
201234059
KY
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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