Individual
MS. MAUREEN MARGARET MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1525 GREENVIEW AVE, PORTAGE, MI 49024-3322
(949) 584-3507
Mailing address
1525 GREENVIEW AVE, PORTAGE, MI 49024-3322
(949) 584-3507
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7529
CA
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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