Individual
TESA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
12340 STATE ROUTE 104, WAVERLY, OH 45690-8968
(740) 941-5170
Mailing address
1534 PLEASANT HILL RD, WAVERLY, OH 45690-9217
(740) 705-0780
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA-4985
OH
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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