Individual
MRS. LAURA OLSEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
136 BRISTOL EAST RD, BRISTOL, VA 24202-5500
(276) 591-5484
(276) 591-5477
Mailing address
PO BOX 16937, BRISTOL, VA 24209-6937
(276) 591-5484
(276) 591-5477
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305001916
VA
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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