Individual
MRS. NICOLE ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2909 HOWARD DR, JASPER, IN 47546-1113
(812) 482-6161
Mailing address
2909 HOWARD DR, JASPER, IN 47546-1113
(812) 482-6161
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003336A
IN
Other
Enumeration date
05/05/2010
Last updated
05/05/2010
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