Individual
TERENCE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
92 TANGLEWOOD DR, GLEN ELLYN, IL 60137-7831
(336) 898-4786
Mailing address
539 W ROOSEVELT RD, #1083, GLEN ELLYN, IL 60137
(336) 898-4786
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.022710
IL
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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