Individual
MRS. DONNA EALISE' MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7485 FALCON ROCK DR, LAS VEGAS, NV 89123-1472
(702) 412-5537
(702) 202-3043
Mailing address
7485 FALCON ROCK DR, LAS VEGAS, NV 89123-1472
(702) 412-5537
(702) 202-3043
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/20/2010
Last updated
11/20/2010
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