Individual
JENNY LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3150 N COBB PKWY STE 150, KENNESAW, GA 30152-1009
(678) 574-6868
Mailing address
153 VINE CREEK PT, ACWORTH, GA 30101-5917
(203) 733-9703
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014591
GA
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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