Individual
MS. CASEY BLYTHE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, SCAT
Contact information
Practice address
3300 PALMETTO HWY, GREENVILLE, SC 29613-0001
(828) 260-1308
Mailing address
7863 CHAMPION WAY, UNIT A, NORTH CHARLESTON, SC 29418-2210
(828) 260-1308
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1258
SC
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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