Individual
BETHANY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2628 N FRASER ST, GEORGETOWN, SC 29440-6946
(843) 520-0319
(843) 545-5267
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(610) 991-2034
(610) 438-2046
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2553
SC
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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