Individual
MARY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
86 ORMOND ST # LL, BOSTON, MA 02126-1508
(617) 581-8063
Mailing address
6 LIBERTY SQ STE 2078, BOSTON, MA 02109-5800
(617) 581-8063
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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