Individual
MS. CARRI T MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
300 E ROYAL LN STE 110, IRVING, TX 75039-3508
(972) 409-0016
Mailing address
300 E ROYAL LN STE 110, IRVING, TX 75039-3508
(972) 409-0016
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
119469
TX
225700000X
Massage Therapist
91543
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119469
STATE ID
TX
Enumeration date
05/01/2014
Last updated
08/29/2020
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