Individual
CRISTAL S MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
514 W 5TH ST, ROCHESTER, IN 46975-1224
(574) 223-3819
Mailing address
514 W 5TH ST, ROCHESTER, IN 46975-1224
(574) 223-3819
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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