Individual
DR. KELSEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441-6200
(763) 545-8850
(763) 544-1257
Mailing address
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441-6200
(763) 545-8850
(763) 544-1257
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3563
MN
152WP0200X
Pediatric Optometrist
3563
MN
152WV0400X
Vision Therapy Optometrist
3563
MN
Other
Enumeration date
07/24/2017
Last updated
02/05/2023
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