Individual
HEATH C.R. MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4554 W 48TH ST, FREMONT, MI 49412-8721
(231) 924-1013
Mailing address
1019 RAMSHORN DR, FREMONT, MI 49412-7893
(231) 414-1239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003641
MI
Other
Enumeration date
09/23/2013
Last updated
09/23/2013
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