Individual
MRS. BETTY LOUISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
26045 SOTTERLEY HEIGHTS RD, HOLLYWOOD, MD 20636-2659
(301) 373-5827
(301) 373-5753
Mailing address
26045 SOTTERLEY HEIGHTS RD, HOLLYWOOD, MD 20636-2659
(301) 373-5827
(301) 373-5753
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14555
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11249615
CAQH
MD
Enumeration date
04/19/2011
Last updated
04/19/2011
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