Individual
ANNETTE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10098 BEAR CREEK RD, LUCASVILLE, OH 45648-9168
(740) 259-5536
Mailing address
1235 SARASUE AVE, PORTSMOUTH, OH 45662-6445
(740) 353-5147
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
01286
OH
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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