Individual
KELBY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 WHITE ST, JACKSONVILLE, NC 28546-6351
(910) 353-7222
Mailing address
225 WHITE ST, JACKSONVILLE, NC 28546-6351
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1892
NC
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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