Individual
MICHAL DESIREE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 E WALNUT LN, PHILADELPHIA, PA 19138-1312
(215) 764-5782
(215) 764-5782
Mailing address
1940 E WALNUT LN, PHILADELPHIA, PA 19138-1312
(215) 764-5782
(215) 764-5782
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG005860
PA
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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