Individual
MR. JONATHAN D MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
434 E HILL ST, NAVASOTA, TX 77868-2428
(832) 248-5677
Mailing address
434 E HILL ST, NAVASOTA, TX 77868-2428
(832) 248-5677
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT109187
TX
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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