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Individual

MR. WENDY MICHEL MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA PHYSICAL THERAPY

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2036
OR
225100000X
Physical Therapist
PT00006261
WA

Other

Enumeration date
08/18/2006
Last updated
07/08/2007
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