Individual
ANNIE LEE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4611 MORTENSEN RD, APT 310, AMES, IA 50014-6227
(641) 895-9929
Mailing address
4611 MORTENSEN RD, APT 310, AMES, IA 50014-6227
(641) 895-9929
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IA
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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