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Individual

MRS. LAURA SIMCHAK MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
3401 N 67TH AVE, PHOENIX, AZ 85033-4517
(623) 691-4032
Mailing address
1530 E ROCKWOOD DR, PHOENIX, AZ 85024-2958
(602) 750-1448

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5964
AZ
2251P0200X
Pediatric Physical Therapist
Primary
5964
AZ

Other

Enumeration date
05/09/2006
Last updated
12/03/2009
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