Individual
MRS. KELLIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2319 PRINCE AVE, ATHENS, GA 30606-6030
(706) 548-7300
(706) 548-7870
Mailing address
2319 PRINCE AVE, ATHENS, GA 30606-6030
(706) 548-7300
(706) 548-7870
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011472
GA
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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