Individual
MS. MELISSA MARIE MOORE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
837 BRIARVIEW DR APT 837, BRIDGEPORT, WV 26330-9626
(304) 672-9274
Mailing address
837 BRIARVIEW DR APT 837, BRIDGEPORT, WV 26330-9626
(304) 672-9274
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001012
WV
225200000X
Physical Therapy Assistant
PTA001012
WV
225200000X
Physical Therapy Assistant
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Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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