Individual
DR. MALLORY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
100 CROFTON PL, PALMYRA, VA 22963-3300
(434) 589-9588
(434) 589-4096
Mailing address
4668 PEMBROKE BLVD STE 115, VIRGINIA BEACH, VA 23455-6423
(757) 648-8562
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305210720
VA
Other
Enumeration date
09/08/2014
Last updated
01/15/2018
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