Individual
KIMBERLY ANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
112 JEFFERSON ST, WEST UNION, IA 52175-1022
(563) 423-7261
Mailing address
112 JEFFERSON ST, WEST UNION, IA 52175-1022
(563) 423-7261
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00750
IA
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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