Individual
MICHAEL ALLEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
235 E MAIN ST, SUITE 104, NORTHVILLE, MI 48167-2494
(248) 349-5050
Mailing address
235 E MAIN ST, SUITE 104, NORTHVILLE, MI 48167-2494
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201006960
MI
Other
Enumeration date
12/16/2010
Last updated
12/16/2010
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