Individual
DR. KELLY ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
1875 W DEMPSTER ST STE G10, PARK RIDGE, IL 60068-1100
(847) 723-7500
Mailing address
1333 W TOUHY AVE APT 103, PARK RIDGE, IL 60068-3164
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070.011258
IL
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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