Individual
ELISE MIRANDA PRINCEHOUSE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
602A FRONT ST, SILVERTON, OR 97381-1428
(503) 874-4416
Mailing address
601 N 1ST AVE, STAYTON, OR 97383-1704
(503) 769-3123
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63267
OR
Other
Enumeration date
05/24/2019
Last updated
07/16/2024
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