Individual
MRS. BLAKELEE ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 NELSON RD, SUITE C12, LAKE CHARLES, LA 70605-4148
(337) 990-5621
(888) 574-7253
Mailing address
4150 NELSON RD, SUITE C12, LAKE CHARLES, LA 70605-4148
(337) 990-5621
(888) 574-7253
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08305
LA
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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