Individual
CHASE MODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
3980 SOUTH JACKSON DR, INDEPENDENCE, MO 64057
(816) 795-1433
Mailing address
3980 SOUTH JACKSON DRIVE, INDEPENDENCE, MO 64057
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2016016879
MO
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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