Individual
JACLYN MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 TELEGRAPH RD, TAYLOR, MI 48180-3330
(248) 408-5103
Mailing address
2315 HAMATA ST, FERNDALE, MI 48220-1549
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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