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Individual

KELVIN MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
PO BOX 22, SENATOBIA, MS 38668-0022

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2229
MS

Other

Enumeration date
06/26/2008
Last updated
08/25/2022
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