Individual
MELODY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
(585) 377-2243
Mailing address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
(585) 377-2243
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006175
NY
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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