Individual
KIMBERLY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
165 SMITH ST, PORTSMOUTH, OH 45662-8767
(740) 821-1008
Mailing address
165 SMITH ST, PORTSMOUTH, OH 45662-8767
(740) 821-1008
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
006542
OH
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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