Individual
SHELBY LAUREN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
334 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-2024
(417) 423-7410
(417) 423-7411
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2014042706
MO
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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