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Individual

ANGELENE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1370 N FAIRFIELD RD, BEAVERCREEK, OH 45432-2675
(937) 429-4263
(937) 429-4865
Mailing address
1370 N FAIRFIELD RD, BEAVERCREEK, OH 45432-2675
(937) 429-4263
(937) 429-4865

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5086
OH

Other

Enumeration date
12/04/2006
Last updated
11/22/2010
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