Individual
MELISSA ANN MOOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2768 FRIENDLY CIR, GREEN BAY, WI 54313-9533
(920) 434-3869
Mailing address
2768 FRIENDLY CIR, GREEN BAY, WI 54313-9533
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1730-19
WI
Other
Enumeration date
03/10/2011
Last updated
03/05/2015
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