Individual
MRS. HEATHER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
20 MILL ST, INMAN, SC 29349-1531
(864) 621-7913
Mailing address
45 N MAIN ST, INMAN, SC 29349-1437
(864) 621-7913
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4509
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4509
MASSAGE LICENSE #
SC
Enumeration date
06/20/2020
Last updated
06/20/2020
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