Individual
KRISTIN S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9945
Mailing address
PO BOX 7005, 14TH AND BROADWAY, QUINCY, IL 62305-7005
(217) 223-8400
(217) 223-9945
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008151
IL
225X00000X
Occupational Therapist
2009205716
MO
Other
Enumeration date
10/27/2009
Last updated
10/29/2009
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